Dario Health, Caesarea, Israel.
Joslin Diabetes Center, Harvard Medical School, Boston, MA, United States.
J Med Internet Res. 2024 Apr 2;26:e54940. doi: 10.2196/54940.
The management of type 2 diabetes (T2D) and obesity, particularly in the context of self-monitoring, remains a critical challenge in health care. As nearly 80% to 90% of patients with T2D have overweight or obesity, there is a compelling need for interventions that can effectively manage both conditions simultaneously. One of the goals in managing chronic conditions is to increase awareness and generate behavioral change to improve outcomes in diabetes and related comorbidities, such as overweight or obesity. There is a lack of real-life evidence to test the impact of self-monitoring of weight on glycemic outcomes and its underlying mechanisms.
This study aims to assess the efficacy of digital self-monitoring of weight on blood glucose (BG) levels during diabetes management, investigating whether the weight changes may drive glucose fluctuations.
In this retrospective, real-world quasi-randomized study, 50% of the individuals who regularly used the weight monitoring (WM) feature were propensity score matched with 50% of the users who did not use the weight monitoring feature (NWM) based on demographic and clinical characteristics. All the patients were diagnosed with T2D and tracked their BG levels. We analyzed monthly aggregated data 6 months before and after starting their weight monitoring. A piecewise mixed model was used for analyzing the time trajectories of BG and weight as well as exploring the disaggregation effect of between- and within-patient lagged effects of weight on BG.
The WM group exhibited a significant reduction in BG levels post intervention (P<.001), whereas the nonmonitoring group showed no significant changes (P=.59), and both groups showed no differences in BG pattern before the intervention (P=.59). Furthermore, the WM group achieved a meaningful decrease in BMI (P<.001). Finally, both within-patient (P<.001) and between-patient (P=.008) weight variability was positively associated with BG levels. However, 1-month lagged back BMI was not associated with BG levels (P=.36).
This study highlights the substantial benefits of self-monitoring of weight in managing BG levels in patients with diabetes, facilitated by a digital health platform, and advocates for the integration of digital self-monitoring tools in chronic disease management. We also provide initial evidence of testing the underlying mechanisms associated with BG management, underscoring the potential role of patient empowerment.
2 型糖尿病（T2D）和肥胖症的管理，尤其是在自我监测的背景下，仍然是医疗保健领域的一个重大挑战。由于近 80%至 90%的 T2D 患者超重或肥胖，因此迫切需要能够同时有效管理这两种疾病的干预措施。管理慢性病的目标之一是提高意识并促进行为改变，以改善糖尿病和相关合并症（如超重或肥胖）的结局。缺乏真实生活证据来测试体重自我监测对血糖结果及其潜在机制的影响。
本研究旨在评估数字体重自我监测在糖尿病管理过程中对血糖（BG）水平的疗效，研究体重变化是否会导致血糖波动。
在这项回顾性、真实世界的准随机研究中，根据人口统计学和临床特征，将定期使用体重监测（WM）功能的 50%个体与未使用体重监测功能（NWM）的 50%个体进行倾向评分匹配。所有患者均被诊断为 2 型糖尿病，并跟踪他们的 BG 水平。我们分析了开始体重监测前 6 个月的每月汇总数据。使用分段混合模型分析 BG 和体重的时间轨迹，并探索体重对 BG 的滞后影响的患者间和患者内离散效应。
WM 组在干预后 BG 水平显著降低（P<.001），而非监测组无显著变化（P=.59），两组在干预前 BG 模式无差异（P=.59）。此外，WM 组的 BMI 显著降低（P<.001）。最后，患者内（P<.001）和患者间（P=.008）体重变异性与 BG 水平呈正相关。然而，1 个月滞后的体重指数与 BG 水平无相关性（P=.36）。
本研究强调了数字健康平台支持下的体重自我监测在管理糖尿病患者 BG 水平方面的重要益处，并提倡将数字自我监测工具整合到慢性病管理中。我们还提供了测试与 BG 管理相关的潜在机制的初步证据，强调了患者赋权的潜在作用。
