Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Aug 10, 2020
Date Accepted: Jan 4, 2021
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
The Effect of an mHealth remote monitoring exercise intervention on clinical outcomes in type 2 diabetes patients: a randomized controlled study
ABSTRACT
Background:
Exercise has been recommended as a cornerstone for diabetes management. Supervised exercise is more effective than unsupervised exercise, but is less convenient and inaccessible for most subjects. Exercise under remote monitoring by fitness app and heart rate band may be useful to improve exercise efficiency.
Objective:
To determine the feasibility and effectiveness of exercise on type 2 diabetes under remote monitoring using fitness app and heart rate monitor compared with traditional exercise.
Methods:
This is a prospective, multi-center, randomized controlled trial (RCT). Type 2 diabetic patients without severe complications or comorbidities were recruited. Both groups were asked to follow the same exercise prescription. The app group was given heart rate band plus remote monitoring by app, while the control group was given traditional exercise guidance. Cardiopulmonary endurance, indices of body composition, and other parameters were assessed before and after intervention. The study had an average follow-up of 3 months.
Results:
101 patients were enrolled and 85 completed the study. With the exception of age and history of hypertension, two groups were similar in most clinical measures. Self-reported total exercise time in control group was longer than app-recorded time in app group (214 vs 193 min/week). However, compared with control group, app group had a larger increase in cardiopulmonary endurance (-2.0 vs 1.0 beats/min, p=0.023) and a larger decrease in body-fat percentage (-1.8 vs-0.8%, p=0.013). There was no difference in HbA1c between two groups, yet four subjects in app group stopped taking hypoglycemic drugs and nine lowered drug dosage, compared with one and two in the control group. There were no serious adverse reactions in both groups.
Conclusions:
This was the first pragmatic RCT in China that tested the feasibility and preliminary efficacy of the effect of exercise under remote monitoring using app and heart rate band. This study suggested that exercise remotely supervised by app and heart rate band were more effective than unsupervised exercise in patients with type 2 diabetes. Clinical Trial: Chinese Clinical Trial Registry number, ChiCTR1800015963
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