1. A personal health record (PHR) app with inspirational notifications was not effective in reducing HbA1c levels and daily steps in people with diabetes compared to controls.
Evidence evaluation level: 1 (great)
The global prevalence of diabetes is expected to increase by 2045, along with the macrovascular and microvascular complications associated with diabetes. Diabetes currently affects 10% of the population, and that number is expected to increase. As the disease becomes more prevalent, it is important to find ways to reduce treatment costs. One well-studied treatment is regular exercise, which has been shown to reduce mortality in affected individuals. In this study, physical activity was assessed by measuring step counts using a personal health record (PHR) app. While all participants were using the application, the intervention group received additional text messages prompting further steps based on baseline activity levels. To assess the effectiveness of PHR, a randomized controlled trial divided participants into a control group that used an app and an intervention group that used an app to receive text messages. The trial began with a 1-week run-in period, followed by a 12-week randomized treatment period, and a 12-week extension period. To best understand the impact of physical activity on type 2 diabetes, change in her daily step count in both groups was assessed as the primary outcome. Secondary outcomes measured average daily step count, average HbA1c level, fasting blood glucose, body weight, physical activity, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and triglycerides. These were all measured over a 2-hour period. A total of 200 participants were divided into two groups, with 62 (93.9%) assigned to the control group and 118 (88.1%) assigned to the intervention group. There was no significant change in daily step count between the two groups (P = 0.365). Among participants whose baseline step count was less than 7500 steps per day, the change in step count after 12 weeks was greater in the intervention group (1319 ± 3020) than in the control group (-139 ± 2309) (P = 0.009). At the same 12-week time point, HbA1c was significantly lower in the intervention group (6.7 ± 0.5% (6.9 ± 0.6%, P = 0.041) compared with the control group; however, when comparing both groups after 24 weeks; As shown in the marks, the changes were significant but comparable between groups: patients with baseline HbA1c ≥ 7.5% had lower HbA1c compared to patients with baseline HbA1c < 7.5%. participants in the intervention group had significant weight loss at weeks 12 and 24 compared to baseline. experienced (-1.07 kg and -1.46 kg, all P < 0.001). In the control group, significant weight loss was observed only at week 24 (-1.05 kg, P = 0.03). Overall, inspired notifications did not increase step count and showed similar changes in HbA1c levels when compared to the control group.
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