Abstract
PurposeRecent trials demonstrated remission of type 2 diabetes and non-alcoholic fatty liver disease (NAFLD) following formula diet-induced weight loss. To improve the outreach for populations in need, many mobile health apps targeting weight loss have been developed with limited scientific evaluation of these apps. The present feasibility study investigated the effects of a novel approach incorporating a regular ‘whole food-based’ low-calorie diet combined with app-based digital education and behavioral change program on glucose metabolism and disease management.MethodsTwenty-four individuals with type 2 diabetes followed this approach supported by weekly coaching calls for 12 weeks. Phenotyping included bioimpedance analysis, mixed-meal tolerance test, magnetic resonance spectroscopy and transient elastography for assessing liver fat content and liver stiffness.ResultsOver 12 weeks, participants reduced their body weight by 9% (97 ± 13 to 88 ± 12 kg), body mass index (BMI; 33 ± 5 to 29 ± 4 kg/m2), total fat mass (31 ± 10 to 27 ± 10%) (all p < 0.01) and liver fat by 50% alongside with decreased liver stiffness. Target HbA1c (< 6.5%) was achieved by 38% and resolution of NAFLD (liver fat content < 5.6%) was observed in 30% of the participants.ConclusionThis novel approach combining digital education with a low-calorie diet results in effective improvements of body weight, glycemic control and NAFLD and could complement existing care for patients with type 2 diabetes.Trial registrationNCT04509245
Highlights
Increased consumption of energy-dense foods, obesity and non-alcoholic fatty liver disease (NAFLD), characterized by hepatocellular lipid content (HCL) of more than 5.6%, are the major metabolic drivers for development of type 2 diabetes [1,2,3]
Moderate weight loss can halt the vicious cycle by normalizing hepatic steatosis, insulin resistance and hyperglycemia [5]
Numerous applications are available for weight loss and diabetes management and mobile health interventions hold great promise to optimize treatment strategies for several chronic diseases, many studies using such applications are of insufficient quality [15, 16]
Summary
Increased consumption of energy-dense foods, obesity and non-alcoholic fatty liver disease (NAFLD), characterized by hepatocellular lipid content (HCL) of more than 5.6%, are the major metabolic drivers for development of type 2 diabetes [1,2,3]. Current nutritional treatment guidelines for adults with type 2 diabetes focus on improving glycemic control, body weight management and cardiovascular risk factors. These guidelines emphasize individualized nutritional therapy, recommendations generally promote healthy whole foods with high fiber content and low added sugars and refined grains [7, 8]. Dietary energy restriction by complete food replacement via formula diets is able to induce diabetes remission and normalization of HCL in a subset of patients [12, 13] It remains unknown whether similar effects can be achieved with a regular, non-formula based diet in connection with digital health education and coaching. To take account of these novel developments and challenges derived thereof, the aim of this feasibility study was to assess whether a combined approach using a ‘real food-based’ low-calorie diet in connection with a smartphone app and weekly coaching calls for patients with diabetes results in improved body weight, metabolism and disease management
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
