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长期结果的一个数字糖尿病自我管理和教育支持计划成年人与 2 型糖尿病:一项回顾性队列研究。

Long-Term Results of a Digital Diabetes Self-Management and Education Support Program Among Adults With Type 2 Diabetes: A Retrospective Cohort Study.

机构信息

Omada Health Inc, San Francisco, California.

Anchor Outcomes LLC, San Francisco, California.

出版信息

Sci Diabetes Self Manag Care. 2024 Feb;50(1):19-31. doi: 10.1177/26350106231221456. Epub 2024 Jan 19.

Abstract

PURPOSE

The purpose of this study is to examine the long-term impact of a digital diabetes self-management education and support (DSMES) program on A1C among adults with type 2 diabetes (T2DM).

METHODS

Data analyzed were from a retrospective cohort of commercially insured members with T2DM enrolled in the Omada for Diabetes program between January 1, 2019, and January 31, 2022 (n = 1,322). Linear mixed models measured changes in A1C and weight across 12 months (collected at baseline and every 3 months over 1 year) overall and stratified by A1C at baseline (≥8% vs <8%).

RESULTS

On average, members were 53.5 years old, 56.9% female, and 71.5% White, with a mean baseline body mass index (BMI) of 36.9 and A1C of 7.6%. Members with baseline A1C ≥8% demonstrated clinically and statistically significant adjusted mean reductions in A1C during follow-up, from 9.48% at baseline to 7.33%, 7.57%, 7.59%, and 7.47% at 3, 6, 9, and 12 months, respectively. Those with A1C <8% maintained glycemic stability (6.73%, 6.50%, 6.54%, 6.62%, and 6.51%, respectively). Collectively, members experienced a -1.17 kg/m mean reduction in BMI over 12 months.

CONCLUSIONS

This study provides real-world evidence that members with elevated baseline A1C (≥8%) enrolled in a digital DSMES program experienced clinically meaningful and statistically significant reductions in A1C. Those with baseline A1C within goal treatment range (<8%) maintained glycemic stability over 1 year. The findings support existing evidence that scalable digital DSMES solutions can help individuals with T2DM manage their condition.

摘要

目的

本研究旨在探讨数字糖尿病自我管理教育和支持(DSMES)计划对 2 型糖尿病(T2DM)成人患者 A1C 的长期影响。

方法

分析的数据来自于 2019 年 1 月 1 日至 2022 年 1 月 31 日期间参加 Omada for Diabetes 计划的商业保险 T2DM 患者的回顾性队列(n=1322)。线性混合模型测量了 12 个月内 A1C 和体重的变化(在基线时收集,并在 1 年内每 3 个月收集一次),总体和按基线 A1C(≥8%与<8%)分层。

结果

平均而言,患者年龄为 53.5 岁,女性占 56.9%,白人占 71.5%,基线时平均体重指数(BMI)为 36.9,A1C 为 7.6%。基线 A1C≥8%的患者在随访期间 A1C 有临床和统计学意义的调整后均值下降,从基线时的 9.48%降至 3、6、9 和 12 个月时的 7.33%、7.57%、7.59%和 7.47%。A1C<8%的患者保持血糖稳定(分别为 6.73%、6.50%、6.54%、6.62%和 6.51%)。总体而言,患者在 12 个月内 BMI 平均降低了 1.17kg/m。

结论

本研究提供了真实世界的证据,表明基线 A1C 升高(≥8%)的患者参加数字 DSMES 计划可显著降低 A1C,具有临床意义。基线 A1C 处于目标治疗范围内(<8%)的患者在 1 年内保持血糖稳定。这些发现支持了现有的证据,即可扩展的数字 DSMES 解决方案可以帮助 T2DM 患者管理病情。

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