One in three American adults has prediabetes, and soon, some Cigna and Blue Cross Blue Shield insurance plans will cover access to online diabetes prevention programs. Both insurers are partnering with Omada Health, a leading digital health company, to provide their all-digital version of the traditional and proven diabetes prevention program.
Caroline Richardson, M.D., the Dr. Max and Buena Lichter Research Professor of Family Medicine, along with colleagues at UCLA, Duke University, the University of Maryland, the Medical College of Wisconsin, the University of Minnesota, and the Veterans Administration, recently examined participation and weight loss results in a version of the Omada Health online diabetes prevention program; an in-person diabetes prevention program; and the Veterans Administration's face-to-face standard-of-care weight management program, called MOVE!
In the primary analysis, enrollees in the online diabetes prevention program saw a mean weight loss of 10.3 pounds at 6 months and 8.8 pounds at 12 months. In a secondary analysis of participants who completed one or more modules/sessions, mean weight loss for online participants was 10.6 pounds at six months and 9 pounds at one year. This was roughly comparable to the results of in-person participants, but significantly higher than it was for MOVE! participants in at least one meeting, who lost 1.1 pounds at six months and 10.6 pounds at one year. In addition, the researchers found that the online program had better participation than the in-person program, with 87 percent of online participants completing eight or more sessions, compared with 59 percent for the in-person program and 55 percent for MOVE!
This study is one of the first to assess weight outcomes in an online diabetes prevention program in comparison to in-person delivery of such a program. Findings from the trial were published in the American Journal of Preventive Medicine.
BACKGROUND
Some 84 million, or one in three, U.S. adults have prediabetes, a condition in which one's blood sugar levels are consistently higher than normal, though not high enough to be type 2 diabetes. Without any intervention, up to 30 percent of adults with prediabetes can develop type 2 diabetes within five years, and up to 70 percent can develop it over their lifetime. Yet type 2 diabetes risk can be lowered by as much as 58 percent with lifestyle interventions such as diabetes prevention programs.
READ MORE: Digital interventions for prediabetics seeking weight loss shown to be effective
METHOD
The trial enrolled 268 obese or overweight veterans with prediabetes in an online program. In a separate trial, 273 were enrolled in an in-person program, and 114 were enrolled in MOVE! This study included only veterans, but participants were recruited from four large centers and were diverse. Participants were not randomly placed in a group and recruitment processes differed between the online and in-person programs.
The online program, developed by Omada Health, consisted of virtual groups of participants; live e-coaches who monitored group interactions and provided the participants with feedback via phone and private online messages; weekly educational modules on healthy eating and exercise; and wireless scales to record participant weights. The in-person program consisted of eight to 22 group-based face-to-face sessions focused on 7 percent weight loss and at least 150 minutes per session of moderate physical activity. The MOVE! program included eight to 12 face-to-face healthy-lifestyle sessions and monthly maintenance sessions, but with no specified goals. Weight change was measured at six months and again at 12 months.
IMPACT
An intensive, multifaceted online diabetes prevention program is as effective as in-person programs and can make prevention programs more accessible to those at risk for developing diabetes.
AUTHORS
First author was Tannaz Moin, M.D., M.B.A., M.S.H.S., assistant professor of medicine at the David Geffen School of Medicine at UCLA and core investigator at Veterans Affairs' Health Services Research & Development Center for the Study of Healthcare Innovation, Implementation and Policy. Senior author was Caroline Richardson, M.D., the Dr. Max and Buena Lichter Research Professor of Family Medicine, University of Michigan. Other researchers were from the Veterans Administration, Duke University, Medical College of Wisconsin, University of Maryland, and the University of Minnesota.
Article citation: Moin T, Damschroder LJ, Auyoung M, et al. Results From a Trial of an Online Diabetes Prevention Program Intervention. American Journal of Preventive Medicine. September 2018. doi:10.1016/j.amepre.2018.06.028.
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