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)
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)
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DOI：
10.2196/jmir.7947
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发表时间：
2017-11-01
影响因子：
7.4
通讯作者：
Roussel, Ronan
中科院分区：
文献类型：
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作者：
Hansel, Boris;Giral, Philippe;Roussel, Ronan
背景：腹部肥胖和 2 型糖尿病 (T2DM) 的流行是一项公共卫生挑战。需要开发新的解决方案来帮助患者改变生活方式。 目的：该研究的目的是评估一种完全自动化的基于网络的干预措施，旨在帮助用户改善饮食习惯并增加身体活动。方法：Accompagnement Nutritionnel de l'Obesite et du Diabete par E-coaching (ANODE) 研究是一项为期 16 周、1:1 平行组、开放标签随机临床试验。招募患有 T2DM 和腹部肥胖的患者（n = 120，年龄 18-75 岁）。干预组的患者 (n= 60) 可以使用全自动程序 (ANODE) 来改善他们的生活方式。要求患者每周至少登录一次。遇到技术问题时，人与人之间的联系仅限于热线支持。饮食工具提供个性化菜单和当天或一周的购物清单。规定逐步进行身体活动。对照组（n = 60）接受一般营养建议。主要结果是基线和研究结束时饮食评分（国际饮食质量指数；DQI-I）的变化。次要终点包括体重、腰围、糖化血红蛋白 (HbA1c) 和测量的最大耗氧量 (VO2 max) 的变化。结果：参与者的平均年龄为 57 岁（标准差 [SD] 9），平均体重指数为 33 kg/m(2) (SD 4)，平均 HbA1c 为 7.2% (SD 1.1)，平均年龄为 66.7% (80/120)。参与者是女性。使用意向治疗分析，与对照组相比，ANODE 组的 DQI-I 评分（ANODE 组为 54.0，SD 5.7；对照组为 52.8，SD 6.2；P=.28）显着增加（+4.55，SD 5.91 vs -1.68，SD 5.18；两组之间 P
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.Method: 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/m(2) (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