Dwibedi Chinmay, Mellergård Emelia, Gyllensten Amaru Cuba, Nilsson Kristoffer, Axelsson Annika S, Bäckman Malin, Sahlgren Magnus, Friend Stephen H, Persson Sofie, Franzén Stefan, Abrahamsson Birgitta, Carlsson Katarina Steen, Rosengren Anders H
Department of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
Faculty of Medicine, Lund University, Lund, Sweden.
NPJ Digit Med. 2022 May 11;5(1):60. doi: 10.1038/s41746-022-00606-9.
The lack of effective, scalable solutions for lifestyle treatment is a global clinical problem, causing severe morbidity and mortality. We developed a method for lifestyle treatment that promotes self-reflection and iterative behavioral change, provided as a digital tool, and evaluated its effect in 370 patients with type 2 diabetes (ClinicalTrials.gov identifier: NCT04691973). Users of the tool had reduced blood glucose, both compared with randomized and matched controls (involving 158 and 204 users, respectively), as well as improved systolic blood pressure, body weight and insulin resistance. The improvement was sustained during the entire follow-up (average 730 days). A pathophysiological subgroup of obese insulin-resistant individuals had a pronounced glycemic response, enabling identification of those who would benefit in particular from lifestyle treatment. Natural language processing showed that the metabolic improvement was coupled with the self-reflective element of the tool. The treatment is cost-saving because of improved risk factor control for cardiovascular complications. The findings open an avenue for self-managed lifestyle treatment with long-term metabolic efficacy that is cost-saving and can reach large numbers of people.
缺乏有效的、可扩展的生活方式治疗方案是一个全球性的临床问题，会导致严重的发病率和死亡率。我们开发了一种促进自我反思和迭代行为改变的生活方式治疗方法，并将其作为一种数字工具提供，同时评估了其对370例2型糖尿病患者的疗效（ClinicalTrials.gov标识符：NCT04691973）。与随机对照和匹配对照（分别涉及158名和204名使用者）相比，该工具的使用者血糖降低，收缩压、体重和胰岛素抵抗也有所改善。这种改善在整个随访期间（平均730天）持续存在。肥胖胰岛素抵抗个体的一个病理生理亚组有明显的血糖反应，这使得能够识别出那些特别受益于生活方式治疗的人。自然语言处理表明，代谢改善与该工具的自我反思元素相关。由于改善了心血管并发症的危险因素控制，该治疗具有成本效益。这些发现为具有长期代谢疗效、成本效益高且能惠及大量人群的自我管理生活方式治疗开辟了一条途径。
