Can a digital and IoT-enabled behaviour change programme achieve >15kg weight loss and 70% type 2 diabetes remission rates?

“2型糖尿病（DM2）在英国影响着410万人。DM2很难控制，许多人需要不止一种药物来控制血糖，而血糖通常伴随着控制高血压或胆固醇的药物。此外，人们还经常接受与DM2相关的其他疾病的治疗，如肾病。从长期来看，DM2与一系列毁灭性的并发症有关，包括失明、下肢截肢和中风。直接临床研究最近表明，快速和大量的减肥，通常是10-15公斤，使用800千卡的饮食12周，可以帮助人们达到健康的血糖水平，减少甚至停止他们的糖尿病药物（当诊断为DM2的人有健康的血糖水平，不再服用糖尿病药物，这被称为“缓解”）。然而，为了达到“缓解”，大多数人需要每周从专业营养师和护士那里得到支持，以安全地进行这种饮食，并养成新的行为习惯，以长期维持他们的体重减轻和健康改善。这方面的主要挑战是，频繁的面对面预约对NHS来说非常昂贵，而且对人们来说不方便，需要请假或从照顾责任中抽出时间来参加预约。难以按时赴约会让人们不太可能坚持节食，也不太可能达到减肥和健康的效果。为了应对这一挑战，Oviva创建了Diabetes-800项目，帮助患有DM2的人减肥150公斤。diabetes -800是一项远程服务，通过电话和NHS Digital批准的Oviva智能手机应用程序，由糖尿病专家营养师和护士提供一对一的支持。该应用程序允许人们监控自己的饮食和目标，并收到个性化的反馈。这种方法最大限度地提高了患者的可及性和灵活性，帮助更多的人减肥，实现缓解，并摆脱糖尿病药物，反过来帮助NHS降低治疗DM2的成本。该项目将添加一个体重秤和活动追踪器，连接到应用程序，以及一个新的机器学习算法，提供鼓励支持，帮助患者更好地实现减肥目标。300年，威斯敏斯特大学将利用来自全科医生实践的DM2对这一改进后的Diabetes-800项目进行评估，以确定它是否能安全地产生与面对面治疗相同的患者益处。这一评估将为英国国家医疗服务体系关于委托此类服务和进一步研究的决策提供信息。”

"Type 2 diabetes (DM2) affects 4.1 million people in the UK. DM2 can be hard to manage, with many people needing more than one medication to control their blood sugars, which often come with medications to manage high blood pressure or cholesterol. Furthermore, people are also often receiving treatment for other conditions linked to their DM2 such as kidney disease.In the long-term, DM2 is associated with a range of devastating complications including blindness, lower limb amputation and stroke.The DiRECT clinical study has recently shown that rapid and substantial weight loss, typically 10-15kg using an 800-kcal diet for 12-weeks, can help people achieve healthy blood-glucose levels and reduce or even stop their diabetes medications (when someone diagnosed with DM2 has a healthy blood-glucose level and is no longer taking diabetes medications, this is called 'remission').However, to achieve 'remission' most people require weekly support from specialist dietitians and nurses to undertake this diet safely, and to develop new behaviours to maintain their weight loss and health improvements in the long term.The main challenge of this is that frequent face-to-face appointments are very costly for the NHS and inconvenient for people to access, requiring time off work or from caring responsibilities to attend appointments. Hard to attend appointments can make people less likely to stay on the diet and achieve weight loss and health benefits.To address this challenge, Oviva has created the Diabetes-800 programme which helps people with DM2 achieve \>15kg weight loss. Diabetes-800 is a remote service, providing one-to-one support from a diabetes specialist dietitian and nurse via the telephone and the NHS Digital approved Oviva smartphone app. The app allows people to monitor their diet and goals which they receive personalised feedback on.This approach maximises accessibility and flexibility for patients, helping more people to lose weight, achieve remission, and come off diabetes medications, in turn helping the NHS reduce the cost of treating DM2\.This project will add a weight scale and activity tracker that connects to the app, as well as a new Machine-Learning algorithm that provides encouraging support, to helping patients better achieve their weight loss goals.This modified Diabetes-800 programme will be evaluated by the University of Westminster in 300 with DM2 from GP practices to see if it can safely generate the same patient benefits as face-to-face approaches. This evaluation will inform NHS decision-making about commissioning such services, and further research."