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)

被引：81

作者：

Hansel, Boris ^{[1
,2
,3
]}

Giral, Philippe ^{[4
,5
,6
]}

Gambotti, Laetitia ^{[7
]}

Lafourcade, Alexandre ^{[7
]}

Peres, Gilbert ^{[6
]}

Filipecki, Claude ^{[8
]}

Kadouch, Diana ^{[1
]}

Hartemann, Agnes ^{[5
,6
,9
]}

Oppert, Jean-Michel ^{[5
,6
,8
]}

Bruckert, Eric ^{[4
,5
,6
]}

Marre, Michel ^{[1
,2
,3
]}

Bruneel, Arnaud ^{[10
]}

Duchene, Emilie ^{[5
]}

Roussel, Ronan ^{[1
,2
,3
,11
]}

机构：

[1] Hop Univ Paris Nord Val de Seine, AP HP, Dept Endocrinol Diabetol Nutr, 46 Rue Henri Huchard, F-75018 Paris, France

[2] Paris Diderot Univ, Sorbonne Paris Cite, Paris, France

[3] INSERM, Ctr Rech Cordeliers, Paris, France

[4] Hop La Pitie Salpetriere, Dept Endocrinol, Paris, France

[5] Inst Cardiometab & Nutr, Paris, France

[6] Univ Paris 06, Sorbonne Univ, Paris, France

[7] Hop La Pitie Salpetriere, Unite Rech Clin, Paris, France

[8] Hop La Pitie Salpetriere, Dept Nutr, Paris, France

[9] Hop La Pitie Salpetriere, Dept Diabetol, Paris, France

[10] Hop Univ Paris Nord Val de Seine, AP HP, Dept Biochem, Paris, France

[11] Dept Hosp Univ, Fibrosis Inflammat Remodelling, Paris, France

来源：

JOURNAL OF MEDICAL INTERNET RESEARCH | 2017年 / 19卷 / 11期

关键词：

e-health; nutrition; type; 2; diabetes; PHYSICAL-ACTIVITY QUESTIONNAIRE; MANAGEMENT; INTERVENTIONS; OVERWEIGHT; OUTCOMES; TOOL;

D O I：

10.2196/jmir.7947

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

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<.001). Body weight, waist circumference, and HbA1c changes improved significantly in the intervention. Conclusions: Among patients with T2DM and abdominal obesity, the use of a fully automated Web-based program resulted in a significant improvement in dietary habits and favorable clinical and laboratory changes. The sustainability of these effects remains to be determined.

引用

页数：14

共 35 条

[1] Text to Move: A Randomized Controlled Trial of a Text-Messaging Program to Improve Physical Activity Behaviors in Patients With Type 2 Diabetes Mellitus [J].