Livongo Health, Mountain View, CA, USA.
Stanford University, Hospital & Clinics, Stanford, CA, USA.
J Diabetes Res. 2018 May 16;2018:3961730. doi: 10.1155/2018/3961730. eCollection 2018.
Connected health devices with lifestyle coaching can provide real-time support for people with type 2 diabetes (T2D). However, the intensity of lifestyle coaching needed to achieve outcomes is unknown.
Livongo provides connected, two-way messaging glucose meters, unlimited blood glucose (BG) test strips, and access to certified diabetes educators. We evaluated the incremental effects of adding lifestyle coaching on BG, estimated HbA1c, and weight. We randomized 330 eligible adults (T2D, HbA1c > 7.5%, BMI ≥ 25) to receive no further intervention ( = 75), a connected scale ( = 115), scale plus lightweight coaching ( = 73), or scale plus intense coaching ( = 67) for 12 weeks. We evaluated the change in outcomes using ANOVA.
Livongo participation alone resulted in improved BG control (mean HbA1c declined: 8.5% to 7.5%, = 0.01). Mean weight loss and additional BG decreases were higher in the intensive compared with the lightweight coaching and scale-only groups (weight change (lb): -6.4, -4.1, and -1.1, resp., = 0.01; BG change (mg/dL): -19.4, -11.3, and -2.9, resp., = 0.02). The estimated 12-week program costs were 5.5 times more for intensive than lightweight coaching.
Livongo participation significantly improves BG control in people with T2D. Additional lifestyle coaching may be a cost-effective intervention to achieve further glucose control and weight loss.
具有生活方式指导的互联健康设备可为 2 型糖尿病（T2D）患者提供实时支持。然而，实现结果所需的生活方式指导强度尚不清楚。
Livongo 提供了互联、双向消息传递血糖仪、无限制的血糖（BG）测试条以及获得认证的糖尿病教育者的访问权限。我们评估了增加生活方式指导对 BG、估计的 HbA1c 和体重的增量效果。我们将 330 名符合条件的成年人（T2D，HbA1c＞7.5％，BMI≥25）随机分为三组，分别为不接受进一步干预（ = 75）、使用互联体重秤（ = 115）、使用互联体重秤加轻量级指导（ = 73）或使用互联体重秤加强化指导（ = 67），干预时长为 12 周。我们使用方差分析评估了结果的变化。
仅参与 Livongo 计划即可改善 BG 控制（平均 HbA1c 下降：8.5％至 7.5％， = 0.01）。与轻量级指导和仅使用体重秤组相比，强化指导组的体重减轻和额外的 BG 降低更高（体重变化（磅）：-6.4、-4.1 和-1.1，分别为 0.01；BG 变化（mg/dL）：-19.4、-11.3 和-2.9，分别为 0.02）。强化指导的 12 周计划成本是轻量级指导的 5.5 倍。
Livongo 计划的参与显著改善了 T2D 患者的 BG 控制。额外的生活方式指导可能是实现进一步血糖控制和体重减轻的具有成本效益的干预措施。
