1. A Fully Automated Web-Based Program Improves Lifestyle Habits and HbA1c in Patients With Type 2 Diabetes and Abdominal Obesity: Randomized Trial of Patient E-Coaching Nutritional Support (The ANODE Study)
- Author
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Ronan Roussel, Alexandre Lafourcade, Agnès Hartemann, Laetitia Gambotti, Arnaud Bruneel, Jean-Michel Oppert, Boris Hansel, Claude Filipecki, Gilbert Peres, Emilie Duchene, Eric Bruckert, Diana Kadouch, Michel Marre, and Philippe Giral
- Subjects
Adult ,Male ,medicine.medical_specialty ,Waist ,020205 medical informatics ,Adolescent ,Health Informatics ,02 engineering and technology ,Type 2 diabetes ,law.invention ,Education, Distance ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Randomized controlled trial ,law ,0202 electrical engineering, electronic engineering, information engineering ,Medicine ,Humans ,030212 general & internal medicine ,Young adult ,Life Style ,Abdominal obesity ,Aged ,Glycated Hemoglobin ,Internet ,Original Paper ,business.industry ,Type 2 Diabetes Mellitus ,VO2 max ,Middle Aged ,medicine.disease ,Telemedicine ,nutrition ,Diabetes Mellitus, Type 2 ,Obesity, Abdominal ,Physical therapy ,e-health ,Female ,type 2 diabetes ,medicine.symptom ,business ,Body mass index - Abstract
Background: The prevalence of abdominal obesity and type 2 diabetes mellitus (T2DM) is a public health challenge. New solutions need to be developed to help patients implement lifestyle changes. Objective: The objective of the study was to evaluate a fully automated Web-based intervention designed to help users improve their dietary habits and increase their physical activity. Methods: The Accompagnement Nutritionnel de l’Obesite et du Diabete par E-coaching (ANODE) study was a 16-week, 1:1 parallel-arm, open-label randomized clinical trial. Patients with T2DM and abdominal obesity (n=120, aged 18-75 years) were recruited. Patients in the intervention arm (n=60) had access to a fully automated program (ANODE) to improve their lifestyle. Patients were asked to log on at least once per week. Human contact was limited to hotline support in cases of technical issues. The dietetic tool provided personalized menus and a shopping list for the day or the week. Stepwise physical activity was prescribed. The control arm (n=60) received general nutritional advice. The primary outcome was the change of the dietary score (International Diet Quality Index; DQI-I) between baseline and the end of the study. Secondary endpoints included changes in body weight, waist circumference, hemoglobin A1c (HbA1c) and measured maximum oxygen consumption (VO2 max). Results: The mean age of the participants was 57 years (standard deviation [SD] 9), mean body mass index was 33 kg/m² (SD 4), mean HbA1c was 7.2% (SD 1.1), and 66.7% (80/120) of participants were women. Using an intention-to-treat analysis, the DQI-I score (54.0, SD 5.7 in the ANODE arm; 52.8, SD 6.2 in the control arm; P=.28) increased significantly in the ANODE arm compared to the control arm (+4.55, SD 5.91 vs -1.68, SD 5.18; between arms P
- Published
- 2017