1
|
Takahashi A, Ishii M, Kino Y, Sasaki K, Matsui T, Arakawa K, Kunisaki M. Effectiveness of a Lifestyle Improvement Support App in Combination with a Wearable Device in Japanese People with Type 2 Diabetes Mellitus: STEP-DM Study. Diabetes Ther 2024; 15:1187-1199. [PMID: 38554220 PMCID: PMC11043275 DOI: 10.1007/s13300-024-01552-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 02/07/2024] [Indexed: 04/01/2024] Open
Abstract
INTRODUCTION Although the use of application (app)s and wearable devices supporting diabetes treatment has spread rapidly in recent years, evidence of their impact, especially in combination of them, is limited. TOMOCO™ is a lifestyle improvement support app that features interactive virtual conversations according to the programmed algorithm guiding users toward their goals of lifestyle improvement. We hypothesized that TOMOCO™ in combination with Fitbit, which accurately tracks users' activity level, would encourage people with type 2 diabetes mellitus (T2DM) to change their lifestyles and improve their glycated hemoglobin (HbA1c) levels without changes in conventional therapy. Thus, we performed the present study to explore the effectiveness of this combination in Japanese participants with T2DM who had not achieved their glycemic targets. METHODS In this single-arm exploratory study, participants with T2DM used the TOMOCO™ and Fitbit in addition to the conventional diet/exercise therapy and anti-diabetic drug for 12 weeks. They were provided with feedback/advice by health care providers based on the TOMOCO™ and Fitbit records. The primary endpoint was the change in HbA1c from baseline to the end of the observation period. Data were expressed as mean ± standard deviation. RESULTS Fifty-nine (96.7%) of the 61 participants (male, 42 [71.2%]; age, 60.1 ± 8.7 years; HbA1c level, 7.48 ± 0.37% at screening) completed the study. At the end of the observation period, the HbA1c was significantly reduced (- 0.41 ± 0.41%, p < 0.001). This trend was consistent across the preselected patient characteristics, including sex, age, and body mass index. However, it was more pronounced in the participants with earlier stages of behavioral changes defined by the transtheoretical model at baseline. CONCLUSIONS The unique features of TOMOCO™ in combination with Fitbit, together with conventional therapy, may promote a healthy lifestyle and thus contribute to improving HbA1c in people with T2DM. CLINICAL TRIAL REGISTRATION jRCT1070220007.
Collapse
Affiliation(s)
- Akiko Takahashi
- Ikuyaku. Integrated Value Development Division, Mitsubishi Tanabe Pharma Corporation, Tokyo, Japan.
| | - Manabu Ishii
- Ikuyaku. Integrated Value Development Division, Mitsubishi Tanabe Pharma Corporation, Tokyo, Japan
| | - Yurika Kino
- Pharma Business Strategy Division, Mitsubishi Tanabe Pharma Corporation, Tokyo, Japan
| | - Kazuyo Sasaki
- Ikuyaku. Integrated Value Development Division, Mitsubishi Tanabe Pharma Corporation, Tokyo, Japan
| | - Takahiro Matsui
- Ikuyaku. Integrated Value Development Division, Mitsubishi Tanabe Pharma Corporation, Osaka, Japan
| | - Kenji Arakawa
- Ikuyaku. Integrated Value Development Division, Mitsubishi Tanabe Pharma Corporation, Tokyo, Japan
| | | |
Collapse
|
2
|
Helmink MAG, Peters SAE, Westerink J, Harris K, Tillmann T, Woodward M, van Sloten TT, van der Meer MG, Teraa M, Dorresteijn JAN, Ruigrok YM, Visseren FLJ, Hageman SHJ. Development and validation of a lifetime prediction model for incident type 2 diabetes in patients with established cardiovascular disease: the CVD2DM model. Eur J Prev Cardiol 2024:zwae096. [PMID: 38584392 DOI: 10.1093/eurjpc/zwae096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 02/19/2024] [Accepted: 02/29/2024] [Indexed: 04/09/2024]
Abstract
AIMS Identifying patients with established cardiovascular disease (CVD) who are at high risk of type 2 diabetes (T2D) may allow for early interventions, reducing the development of T2D and associated morbidity. The aim of this study was to develop and externally validate the CVD2DM model to estimate the 10-year and lifetime risks of T2D in patients with established CVD. METHODS AND RESULTS Sex-specific, competing risk-adjusted Cox proportional hazard models were derived in 19 281 participants with established CVD and without diabetes at baseline from the UK Biobank. The core model's pre-specified predictors were age, current smoking, family history of diabetes mellitus, body mass index, systolic blood pressure, fasting plasma glucose, and HDL cholesterol. The extended model also included HbA1c. The model was externally validated in 3481 patients from the UCC-SMART study. During a median follow-up of 12.2 years (interquartile interval 11.3-13.1), 1628 participants with established CVD were diagnosed with T2D in the UK Biobank. External validation c-statistics were 0.79 [95% confidence interval (CI) 0.76-0.82] for the core model and 0.81 (95% CI 0.78-0.84) for the extended model. Calibration plots showed agreement between predicted and observed 10-year risk of T2D. CONCLUSION The 10-year and lifetime risks of T2D can be estimated with the CVD2DM model in patients with established CVD, using readily available clinical predictors. The model would benefit from further validation across diverse ethnic groups to enhance its applicability. Informing patients about their T2D risk could motivate them further to adhere to a healthy lifestyle.
Collapse
Affiliation(s)
- Marga A G Helmink
- Department of Vascular Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Sanne A E Peters
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- The George Institute for Global Health, Imperial College London, London, UK
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Jan Westerink
- Department of Vascular Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
- Department of Internal Medicine, Isala, Zwolle, The Netherlands
| | - Katie Harris
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Taavi Tillmann
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Mark Woodward
- The George Institute for Global Health, Imperial College London, London, UK
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Thomas T van Sloten
- Department of Vascular Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Manon G van der Meer
- Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Martin Teraa
- Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jannick A N Dorresteijn
- Department of Vascular Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Ynte M Ruigrok
- Department of Neurology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Frank L J Visseren
- Department of Vascular Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Steven H J Hageman
- Department of Vascular Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| |
Collapse
|
3
|
Montero-Sandiego E, Ruiz-Robledillo N, Ferrer-Cascales R, Clement-Carbonell V, Alcocer-Bruno C, Albaladejo-Blázquez N. Spanish validation of the simple lifestyle indicator questionnaire: validity and reliability analysis. Front Public Health 2024; 11:1146010. [PMID: 38264245 PMCID: PMC10803412 DOI: 10.3389/fpubh.2023.1146010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 12/19/2023] [Indexed: 01/25/2024] Open
Abstract
Introduction It has been shown that lifestyle is a highly modifiable determinant having a direct effect on the health status. Therefore, short and simple questionnaires assessing the lifestyle of the general and clinical population are needed to create interventions on behavioral aspects that can improve the health status. The Simple Lifestyle Indicator Questionnaire (SLIQ) is a validated health scale in English that combines five lifestyle factors: diet, exercise, alcohol consumption, tobacco use, and stress level. The objective of this study was to validate the SLIQ questionnaire in Spanish by analyzing the scale's validity and reliability. Its discriminatory power of the scale was also examined by evaluating the differences in health outcomes according to the levels of adherence to a healthy lifestyle. Methods The sample consisted of 745 participants with an average age of 39.94 (SD: 16.99). A transcultural adaptation process was carried out to validate the SLIQ questionnaire in the Spanish context, to determinate the structural equivalence of the Spanish version as compared to the English version, and to assess the psychometric properties of the scale. PREDIMED and IPAQ scales were used to analyze the convergent validity of the Spanish version of the SLIQ regarding to diet and exercise, and the questionnaires SF-12 and DASS-21 questionnaires were used to assess the capacity of the Spanish version of the SLIQ to discriminate health status related to different levels of reported lifestyles. Results Regarding validity, the results indicate significant correlations between the different dimensions of the SLIQ questionnaire and those used as a reference. As for reliability, the test-retest analyses reveal a high temporal consistency for the scores obtained on the questionnaire. Finally, the differences found in anxiety, depression, and quality of life, with regard to the different levels of adherence in the SLIQ questionnaire, suggest that the questionnaire's Spanish version has adequate discriminatory power. Discussion The obtained correlation coefficients between the SLIQ and the other standardized measures pointed out the adequate convergent validity of the instrument. Moreover, the test-retest results demonstrated the stability of the results obtained through this questionnaire. Finally, the lifestyle categories derived from the SLIQ showed a high ability to discriminate between participants' health profiles. Hence, it can be concluded that the Spanish version of the SLIQ questionnaire is a valid and reliable tool for the quick and effective assessment of lifestyle.
Collapse
Affiliation(s)
| | - Nicolás Ruiz-Robledillo
- Department of Health Psychology, Faculty of Health Science, University of Alicante, Alicante, Spain
| | | | | | | | | |
Collapse
|