An Innovative, Paradigm-Shifting Lifestyle Intervention to Reduce Glucose Excursions With the Use of Continuous Glucose Monitoring to Educate, Motivate, and Activate Adults With Newly Diagnosed Type 2 Diabetes: Pilot Feasibility Study.

continuous glucose monitoring diabetes diabetes distress distress glycemic excursion minimization initial treatment intervention lifestyle monitoring motivation. pilot study treatment type 2 diabetes

Journal

JMIR diabetes
ISSN: 2371-4379
Titre abrégé: JMIR Diabetes
Pays: Canada
ID NLM: 101719410

Informations de publication

Date de publication:
23 Feb 2022
Historique:
received: 24 10 2021
accepted: 13 01 2022
revised: 17 12 2021
pubmed: 21 1 2022
medline: 21 1 2022
entrez: 20 1 2022
Statut: epublish

Résumé

Type 2 diabetes (T2D) is a growing epidemic in the United States, and metabolic control has not been improved over the last 10 years. Glycemic excursion minimization (GEM) is an alternative lifestyle treatment option focused on reducing postnutrient glucose excursions rather than reducing weight. GEM has been proven to be superior to routine care when delivered face to face, and equivalent or superior to conventional weight loss therapy, but it has not been evaluated among patients newly diagnosed with T2D or in a self-administered format. This pilot study evaluated the feasibility of a self-administered version of GEM, augmented with continuous glucose monitoring (CGM), to improve metabolic control (hemoglobin A GEM was self-administered by 17 adults recently diagnosed with T2D (mean age 52 years, SD 11.6 years; mean T2D duration 3.9 months, SD 2.5 months; mean HbA At 3-month follow-up, 67% of the participants' diabetes was in remission (HbA GEM augmented with CGM feedback may be an effective initial intervention for adults newly diagnosed with T2D. A self-administered version of GEM may provide primary care physicians and patients with a new tool to help people recently diagnosed with T2D achieve remission independent of medication and without weight loss as the primary focus. Future research is needed with a larger and more diverse sample.

Sections du résumé

BACKGROUND BACKGROUND
Type 2 diabetes (T2D) is a growing epidemic in the United States, and metabolic control has not been improved over the last 10 years. Glycemic excursion minimization (GEM) is an alternative lifestyle treatment option focused on reducing postnutrient glucose excursions rather than reducing weight. GEM has been proven to be superior to routine care when delivered face to face, and equivalent or superior to conventional weight loss therapy, but it has not been evaluated among patients newly diagnosed with T2D or in a self-administered format.
OBJECTIVE OBJECTIVE
This pilot study evaluated the feasibility of a self-administered version of GEM, augmented with continuous glucose monitoring (CGM), to improve metabolic control (hemoglobin A
METHODS METHODS
GEM was self-administered by 17 adults recently diagnosed with T2D (mean age 52 years, SD 11.6 years; mean T2D duration 3.9 months, SD 2.5 months; mean HbA
RESULTS RESULTS
At 3-month follow-up, 67% of the participants' diabetes was in remission (HbA
CONCLUSIONS CONCLUSIONS
GEM augmented with CGM feedback may be an effective initial intervention for adults newly diagnosed with T2D. A self-administered version of GEM may provide primary care physicians and patients with a new tool to help people recently diagnosed with T2D achieve remission independent of medication and without weight loss as the primary focus. Future research is needed with a larger and more diverse sample.

Identifiants

pubmed: 35050857
pii: v7i1e34465
doi: 10.2196/34465
pmc: PMC8908197
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e34465

Informations de copyright

©Tamara K Oser, Mark Cucuzzella, Marilyn Stasinopoulos, Matthew Moncrief, Anthony McCall, Daniel J Cox. Originally published in JMIR Diabetes (https://diabetes.jmir.org), 23.02.2022.

Références

Diabetes Ther. 2017 Aug;8(4):863-873
pubmed: 28646411
Diabetes Care. 2021 Jul 7;:
pubmed: 34244332
Vasc Health Risk Manag. 2010 Mar 24;6:145-55
pubmed: 20448799
J Endocr Soc. 2020 Aug 18;4(11):bvaa118
pubmed: 33094208
Chronic Illn. 2021 Dec;17(4):451-462
pubmed: 31653175
Diabetes Res Clin Pract. 2016 Jan;111:28-35
pubmed: 26556234
Diabetologia. 2021 Nov;64(11):2359-2366
pubmed: 34458934
Ann Intern Med. 2019 May 21;170(10):682-690
pubmed: 31009939
Diabetes Care. 1984 Jan-Feb;7(1):36-41
pubmed: 6705664
Diabetes Care. 2000 Jun;23(6):739-43
pubmed: 10840988
BMJ Open Diabetes Res Care. 2021 Nov;9(2):
pubmed: 34845062
Med Care. 2017 Apr;55(4):391-397
pubmed: 27753746
J Gen Intern Med. 2001 Sep;16(9):606-13
pubmed: 11556941
J Clin Endocrinol Metab. 2006 Mar;91(3):813-9
pubmed: 16352690
J Clin Endocrinol Metab. 2019 Oct 1;104(10):4356-4364
pubmed: 31127824
J Diabetes Sci Technol. 2021 Jan;15(1):134-140
pubmed: 31282179
Diabetes Care. 2018 Dec;41(12):2669-2701
pubmed: 30291106
Patient Prefer Adherence. 2020 Mar 11;14:569-580
pubmed: 32210542
Lancet. 1998 Sep 12;352(9131):837-53
pubmed: 9742976
BMJ Open Diabetes Res Care. 2020 Dec;8(2):
pubmed: 33328160
World J Diabetes. 2015 May 15;6(4):613-20
pubmed: 25987958
Diabetes Technol Ther. 2012 Jul;14(7):630-4
pubmed: 22524548
JMIR Mhealth Uhealth. 2020 Jul 21;8(7):e17534
pubmed: 32706738
Diabetes Care. 2003 Mar;26(3):881-5
pubmed: 12610053
N Engl J Med. 2013 Apr 25;368(17):1613-24
pubmed: 23614587
Diabetes Care. 2005 Mar;28(3):626-31
pubmed: 15735199

Auteurs

Tamara K Oser (TK)

Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, United States.

Mark Cucuzzella (M)

Department of Family Medicine, West Virginia University School of Medicine, Morgantown, WV, United States.

Marilyn Stasinopoulos (M)

Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, United States.

Matthew Moncrief (M)

Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, United States.

Anthony McCall (A)

Department of Medicine: Endocrinology and Metabolism, University of Virginia School of Medicine, Charlottesville, VA, United States.

Daniel J Cox (DJ)

Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, United States.

Classifications MeSH