Participating in an online diabetes prevention program (DPP) may be more effective for weight loss than taking part in an in-person diabetes prevention program, according to researchers from the University of California at Los Angeles and the Veterans Administration.
In the primary phase of the research, those who were enrolled in the online DPP saw an average weight loss of 10.3 pounds at 6 months and 8.8 pounds at 12 months.
In a secondary analysis, participants who completed one or more sessions, average 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 those enrolled in the Veterans Administration’s standard-of-care weight management program, called MOVE!
For those enrolled in MOVE!, a face-to-face program, participants 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!
“We found that the online DPP led to significantly more weight loss and higher participation rates as compared to MOVE!,” Dr. Tannaz Moin, assistant professor of medicine in the division of endocrinology, diabetes, and metabolism at the University of California, Los Angeles told dLife.
“Thus, findings from this study indicate that online DPP was more effective than MOVE! in this group of patients who all completed at least one session,” she says.
This study is one of the first to assess weight outcomes in an online diabetes prevention program in comparison to the in-person delivery of such a program.
According to Moin, everyone participating in this study was overweight/obese and had prediabetes, however, the study was not powered to examine rates of incident diabetes.
How was the Study Conducted?
The trial enrolled 268 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.
From the results, researchers conclude 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.
Why Are Online DPPs More Successful?
Moin explains her and her colleagues’ study tested a multifaceted and intensive version of an online DPP intervention, which may have contributed to patient success.
“Participants were in closed online groups with trained coaches and their progress towards DPP goals were tracked closely, including the use of a wireless home scale,” Moin explains.
“There are many options available for online DPP on the market today so patients with prediabetes should review the different options to see which program features may work best for them,” she suggests.
Moin says interested individuals can start by checking the national registry of recognized DPP lists contact information for all CDC-recognized organizations that deliver evidence-based DPPs (online, in-person and hybrid) in communities across the United States. The registry can be found here.
Online DPP programs, however, may not be easily accessible to veterans.
“Veterans would need to pay out of pocket to participate in an online DPP since this is not a covered benefit in the VA,” Moin points out.
“Online DPP fees vary between vendors but program costs, which can range around $120/month, may be a significant barrier for many veterans.”
Researchers from Duke University, Medical College of Wisconsin, University of Maryland, the University of Minnesota and the University of Michigan were involved in the study.
The VA Quality Enhancement Research Initiative, VA National Center for Health Promotion and Disease Prevention funded the research.
Details are published in the American Journal of Preventive Medicine.