Mark A Berman|Nicole L Guthrie|Katherine L Edwards|Kevin J Appelbaum|Valentine Njike|David M. Eisenberg|David L. Katz
Change in Glycemic Control With Use of a Digital Therapeutic in Adults With Type 2 Diabetes: Cohort Study
Griffin Hospital|Harvard University|Griffin Hospital
background intensive lifestyle change treat even reverse type 2 diabetesdigital therapeutics potential deliver lifestyle medicine diabetes scaleobjective 12week study investigates effects novel digital therapeutic farewell hemoglobin 1c hba 1c diabetes medication use methodsadults type 2 diabetes mobile phone recruited throughout united states using facebook advertisementsthe intervention aim effect sustainable shift plantbased dietary pattern regular exercise advancing culinary literacy lifestyle skill acquisitionthe intervention delivered app paired specialized human support also delivered digitallyhealth coaching provided every 2 weeks telephone clinical team available participants requiring additional supportparticipants selfreported current medications hba 1c beginning end 12week programselfefficacy related managing diabetes maintaining dietary changes assessed via surveyengagement recorded automatically app resultswe enrolled 118 participants baseline hba 1c 65participants 814 female 96118 resided 38 us states mean age 507 sd 94 years baseline body mass index 381 sd 88 kgm 2 baseline hba 1c 81 sd 16at 12 weeks 862 94109 participants still using appmean change hba 1c 08 97101 sd 13 p001 reporting endstudy datafor participants baseline hba 1c 70 change medications midstudy hba 1c change 11 6769 sd 14 p001the proportion participants endstudy hba 1c 65 28 2297after completion intervention 17 1697 participants reported decrease diabetic medication 8 897 reported increasea total 57 5597 participants achieved composite outcome reducing hba 1c reducing diabetic medication use 92 9098 reported greater confidence ability manage diabetes compared program 91 8998 reported greater confidence ability maintain healthy dietary patternparticipants engaged app average 43 times per daywe observed significantly greater decrease hba 1c among participants highest tertile app engagement compared lowest tertile app engagement p03 conclusionsclinically meaningful reductions hba 1c observed use farewell digital therapeuticgreater glycemic control observed increasing app engagementengagement retention high widely distributed sample