JMIR Publications

ABSTRACT

Background:

The management of type 2 diabetes (T2D) and obesity, particularly in the context of self-monitoring, remains a critical challenge in healthcare. As nearly 80–90% of T2D patients are overweight or obese, there is a compelling need for interventions that can effectively manage both conditions simultaneously. One of the goals in chronic condition management is to increase awareness and generate behavioral change to improve outcomes in diabetes and related comorbidities, such as overweight or obesity. There is a lack of real-life evidence to test the impact of weight self-monitoring glycemic outcomes and its underlying mechanisms.

Objective:

This study aimed to assess the efficacy of digital weight self-monitoring on blood glucose (BG) levels during diabetes management, testing whether the weight changes may drive glucose fluctuations.

Methods:

In this retrospective, real-world quasi-randomized study, 966 individuals who regularly used the weight-monitoring feature (WM) were propensity score-matched with 966 users who did not (NWM) based on demographic and clinical characteristics. All the patients were diagnosed with type 2 diabetes (T2D) and tracked their BG levels. We analyzed monthly-aggregated data six months before and after starting their weight monitoring. A piecewise mixed model was used for analyzing the time trajectories of BG, weight, also exploring the disaggregation effect of between - and within-patient lagged effects of weight on BG.

Results:

The weight-monitoring group exhibited a significant reduction in BG levels post-intervention (P<0.001), while the non-monitoring group showed no significant changes (P=0.59), while both groups showed no differences in BG pattern before the intervention (P=0.59). Furthermore, the WM group achieved a meaningful decrease in BMI (P<0.001). Finally, both within- (P<0.001) and between-patient (P=0.008) weight variability were positively associated with BG levels. However, 1-month-lagged back BMI was not associated with BG levels (P=0.36).

Conclusions:

This study highlights the substantial benefits of self-weight monitoring in managing blood glucose levels in patients with diabetes, facilitated by a digital health platform and advocating for the integration of digital self-monitoring tools in chronic disease management. We also provide initial evidence of testing the underlying mechanisms associated with BG management, underscoring the potential role of patient empowerment.