Novel App- and Web-Supported Diabetes Prevention Program to Promote Weight Reduction, Physical Activity, and a Healthier Lifestyle: Observation of the Clinical Application.

Abstract

The increasing incidence of type 2 diabetes mellitus presents as a tsunami of health problems and health care costs. Preventing this development needs to target the underlying rise in metabolic syndrome cases through obesity and unhealthy lifestyle. Obesity is frequently perceived as a social issue with implicit psychological strain; health apps/weight-reduction programs are mushrooming from this side. The present program intends to bring weight reduction into the hands of HCPs by utilizing advanced digital technology. The prospective observational study analyzed 166 patients with metabolic syndrome as treated for weight reduction in 23 medical practices in Germany. Two approaches were observed: usual care (UC; n = 57) and a personalized health management program (PHM; n = 109). Key for PHM was the interaction between HCP and patient: reinforcing lifestyle changes through personalized goals and HCP-feedback via app- and web-based communication. Comparing PHM/UC was based on a time-to-success (5% weight reduction) analysis by Cox regression. Further exploratory analyses addressed the comparison of achievers and nonachievers. Cox regression adjusted for sex, age, and BMI revealed a chance ratio for weight reduction of 6.2 (2.4-16.2, p = .0003) favoring PHM. Expected success rates were 44.8% for PHM, 11.5% for UC. PHM achievers reduced their weight by 8.0% and lowered their BMI by 2.7 points. Motivation for lifestyle changes represented a key for success. The approach of enhanced interaction of HCPs and patients via app- and web-based communication was a clear success and delivered favorable responder rates. Treating obesity from a medical viewpoint will help to deepen the motivation for changing lifestyles. The study represents a cornerstone for a wider scoped application of these novel digital health approaches.