TY - JOUR
T1 - Association between weight loss and glycemic outcomes
T2 - A post hoc analysis of a remote patient monitoring program for diabetes management
AU - Michaud, Tzeyu L.
AU - Siahpush, Mohammad
AU - Estabrooks, Paul
AU - Schwab, Robert J.
AU - Levan, Tricia D.
AU - Grimm, Brandon
AU - Ramos, Athena K.
AU - Johansson, Patrik L
AU - Scoggins, Dylan
AU - Su, Dejun
N1 - Funding Information:
The RPM program as described in this study was supported by grant number 1C1CMS331344 from the Department of Health and Human Services, Centers for Medicare & Medicaid Services (CMS). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the article. The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies. The research presented here was conducted by the awardee. Findings from this study might or might not be consistent with or confirmed by the findings of the independent evaluation contractor hired by the CMS.
Publisher Copyright:
© 2020, Mary Ann Liebert, Inc.
PY - 2020/5
Y1 - 2020/5
N2 - Background: Evidence-based guidelines for the management of type 2 diabetes (T2D) consist of blood glucose monitoring, medication adherence, and lifestyle modifications that may particularly benefit from reminders, consultation, education, and behavioral reinforcements through remote patient monitoring (RPM). Objectives: To identify predictors of weight loss and to examine the association between weight loss and hemoglobin A1C (HbA1C) outcomes for T2D patients who were enrolled in an RPM program for diabetes management. Materials and Methods: The study applied logistic and ordinary least-squares regression models to examine the relationship between baseline characteristics and the likelihood of weight loss during the RPM, and how the magnitude of weight loss was related to changes in HbA1C outcomes for 1,103 T2D patients who went through 3 months of RPM from 2014 to 2017. Results: Older patients were 3% more likely to have weight loss (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.02-1.05), whereas patients with higher baseline HbA1C had 9% reduced odds (OR, 0.91; 95% CI, 0.85-0.97) of experiencing weight loss. For every pound of weight lost, there was a 0.02-point (95% CI, 0.01-0.03) reduction on the HbA1C measured at the end of the RPM. Moreover, compared with those who had weight loss of ≤3%, participants who had lost 5-7%, or >7% of their baseline weight had a 0.37- and 0.58-point reduction in HbA1C, respectively. Conclusions: This study revealed a notable relationship between weight loss and positive HbA1C outcomes for T2D patients in an RPM-facilitated diabetes management program, which pointed to the potential of integrating evidence-based lifestyle modification programs into future telemedicine programs to improve diabetes management outcomes.
AB - Background: Evidence-based guidelines for the management of type 2 diabetes (T2D) consist of blood glucose monitoring, medication adherence, and lifestyle modifications that may particularly benefit from reminders, consultation, education, and behavioral reinforcements through remote patient monitoring (RPM). Objectives: To identify predictors of weight loss and to examine the association between weight loss and hemoglobin A1C (HbA1C) outcomes for T2D patients who were enrolled in an RPM program for diabetes management. Materials and Methods: The study applied logistic and ordinary least-squares regression models to examine the relationship between baseline characteristics and the likelihood of weight loss during the RPM, and how the magnitude of weight loss was related to changes in HbA1C outcomes for 1,103 T2D patients who went through 3 months of RPM from 2014 to 2017. Results: Older patients were 3% more likely to have weight loss (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.02-1.05), whereas patients with higher baseline HbA1C had 9% reduced odds (OR, 0.91; 95% CI, 0.85-0.97) of experiencing weight loss. For every pound of weight lost, there was a 0.02-point (95% CI, 0.01-0.03) reduction on the HbA1C measured at the end of the RPM. Moreover, compared with those who had weight loss of ≤3%, participants who had lost 5-7%, or >7% of their baseline weight had a 0.37- and 0.58-point reduction in HbA1C, respectively. Conclusions: This study revealed a notable relationship between weight loss and positive HbA1C outcomes for T2D patients in an RPM-facilitated diabetes management program, which pointed to the potential of integrating evidence-based lifestyle modification programs into future telemedicine programs to improve diabetes management outcomes.
KW - diabetes
KW - e-health
KW - home monitoring
KW - telehealth
KW - telemedicine
UR - http://www.scopus.com/inward/record.url?scp=85084660057&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85084660057&partnerID=8YFLogxK
U2 - 10.1089/tmj.2019.0030
DO - 10.1089/tmj.2019.0030
M3 - Article
C2 - 31411552
AN - SCOPUS:85084660057
SN - 1530-5627
VL - 26
SP - 621
EP - 628
JO - Telemedicine and e-Health
JF - Telemedicine and e-Health
IS - 5
ER -