Comparison of an online versus conventional multidisciplinary collaborative weight loss programme in type 2 diabetes mellitus: A randomized controlled trial.
Yun Han, Xinhua Ye, Xiaona Li and 5 others
PMID 36567135WHAT IT FOUND
An online multidisciplinary weight-loss programme improved blood sugar control, self-management and quality of life over 12 months compared with conventional outpatient care in adults with type 2 diabetes and overweight or obesity.
Key findings
01The primary endpoint was HbA1c one year after intervention, and HbA1c was one of the glucose outcomes showing significant between-group differences at several time points in both per-protocol and intention-to-treat analyses.
02Self-management scores for diet control, foot care and total score were significantly higher in the online group than in controls.
03Quality-of-life scores decreased over 12 months in both groups, and the online group had lower scores than the conventional group at 3, 6 and 12 months; because higher scores mean worse quality of life, this indicates better quality of life in the online group.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
It was a single-centre trial, so results may not apply to other hospitals or health systems. Follow-up was 12 months, and the authors noted this was relatively short. Participants were mainly young and middle-aged adults aged 18 to 60, so older patients were not well represented. Recruitment was by convenience sampling, and patients needed to use smartphones, read Chinese and tolerate exercise, which may limit generalisability. The online arm was a package of many components, so it is not possible to tell whether the WeChat platform, the multidisciplinary team, education, monitoring, exercise advice or follow-up caused the improvements. Seven patients were missing or dropped out before the first follow-up, and per-protocol and intention-to-treat results differed for some outcomes, including weight and lipid measures. Cardiovascular benefits were not comprehensively assessed.
The easy way to misread this
Do not conclude that the WeChat platform alone improved blood sugar. The online arm combined the platform with a nurse-led multidisciplinary team, dietitian, sports coach, psychological consultant and physician input, educational courses, diet and exercise recording, wearable body measurements, homework feedback and regular follow-up, so the contribution of any single component cannot be separated. Weight and lipid findings also differed between per-protocol and intention-to-treat analyses.