Effectiveness of a ketogenic diet and virtual coaching intervention for patients with diabetes: A difference-in-differences analysis.
Effectiveness of a ketogenic diet and virtual coaching intervention for patients with diabetes: A difference-in-differences analysis.
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DOI：
10.1111/dom.14515
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发表时间：
2021-12
期刊：
影响因子：
--
通讯作者：
Conlin PR
中科院分区：
文献类型：
--
作者：
Strombotne KL;Lum J;Ndugga NJ;Utech AE;Pizer SD;Frakt AB;Conlin PR
测试生酮饮食和虚拟指导干预在控制糖尿病护理和医疗保健利用标志物方面的有效性。我们使用等候名单对照组的差异中差异分析（一种准实验方法）估计了HbA 1c、体重指数、血压、处方药使用和成本以及医疗保健利用的5个月变化。该分析包括590名糖尿病患者，他们也超重或肥胖，并且经常利用退伍军人健康管理局（VA）进行医疗保健。我们使用了2018年至2020年VA电子健康记录的数据。生酮饮食和虚拟指导干预与HbA 1c显著降低相关（−0.69 [95% CI −1.02，−0.36]），糖尿病药物填充（−0.38，[−0.49，−0.26]），体重指数（−1.07，[−1.95，−0.19]），舒张压水平（-1.43，[-2.72，-0.14]）、门诊就诊（-0.36，[-0.70，-0.02]）和处方药费用（-34.54 [-48.56，-20.53]）。我们发现急诊就诊（-0.02 [-0.05，0.01]）或住院（-0.01 [-0.02，0.01]）没有显著变化。这种对虚拟指导和饮食计划的真实评估表明，这种干预措施对糖尿病患者的糖尿病护理和医疗保健利用的标志物提供了短期益处。
To test the effectiveness of a ketogenic diet and virtual coaching intervention in controlling markers of diabetes care and healthcare utilization. Using a difference-in-differences analysis with a waiting list control group—a quasi-experimental methodology—we estimated the 5-month change in HbA1c, body mass index, blood pressure, prescription medication use and costs, as well as healthcare utilization. The analysis included 590 patients with diabetes who were also overweight or obese, and who regularly utilize the Veterans Health Administration (VA) for healthcare. We used data from VA electronic health records from 2018 to 2020. The ketogenic diet and virtual coaching intervention was associated with significant reductions in HbA1c (−0.69 [95% CI −1.02, −0.36]), diabetes medication fills (−0.38, [−0.49, −0.26]), body mass index (−1.07, [−1.95, −0.19]), diastolic blood pressure levels (−1.43, [−2.72, −0.14]), outpatient visits (−0.36, [−0.70, −0.02]) and prescription drug costs (−34.54 [−48.56, −20.53]). We found no significant change in emergency department visits (−0.02 [−0.05, 0.01]) or inpatient admissions (−0.01 [−0.02, 0.01]). This real-world assessment of a virtual coaching and diet programme shows that such an intervention offers short-term benefits on markers of diabetes care and healthcare utilization in patients with diabetes.
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