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The eHealth Diabetes Remission Trial - Pilot Study

Not Applicable
Completed
Conditions
Type 2 Diabetes
Interventions
Behavioral: Diabetes remission using total diet replacement and eHealth contact with the healthcare provider
Registration Number
NCT04805996
Lead Sponsor
Julia Otten
Brief Summary

Ten study participants will consume a low-calorie total diet replacement for 12 weeks, have a 6-week food reintroduction phase (week 13-18) and continue with the weight loss maintenance phase until the end of the study (week 19-26). The weight loss goal is 15 kg (or 15% if body weight is bellow 80 kg). The primary study outcome iw weight loss after 6 months and the co-primary outcome is diabetes remission after 6 months (HbA1c \< 48 mmol/mol). During the weight maintenance phase, if weight regain occurs or if HbA1c increases a rescue plan of total diet replacement will be recommended.

The participants will be supplied with the total diet replacement Modifast free of charge. Participants will be supplied with a scale, a finger-stick blood glucose meter and a blood pressure monitor. Participants will be advised to measure body weight, blood glucose and blood pressure every morning. The results are registered in the mobile phone application Telia Health Monitoring and are wirelessly transmitted to the project's physician, nurse and dietician. At the beginning of the food reintroduction phase the participants will receive an activity tracer and will be advised to increase their physical activity. Primary and secondary outcome measures will be estimated at the beginning and after 3 and 6 months. At the end of the study, all participants will take part in an individual semi-structured interview to investigate the participants' experience of diabetes remission and of the eHealth contact with the healthcare provider. After participants have completed the study, they will be followed at least once per year by obtaining data on blood sugar, HbA1c, body weight, blood pressure, medication usage and diabetes complications from the healthcare computer system.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
10
Inclusion Criteria
  • Type 2 diabetes with diabetes duration 0 to 6 years
  • BMI 27-45 kg/m2
  • Owning a smartphone
  • HbA1c 43-107 mmol/mol during the past 12 months (48-107 mmol/mol without blood sugar lowering medication)
Exclusion Criteria
  • Insulin treatment
  • Weight loss 5 kg or more during the past 6 months
  • Treatment with weight loss medication
  • Diagnosed eating disorder
  • eGFR < 30 ml/min/1.73m2
  • Substance abuse
  • Cancer
  • Myocardial infarction during the past 6 months
  • Severe heart failure
  • Pregnancy

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Diabetes remission using total diet replacement and eHealth contact with the healthcare providerDiabetes remission using total diet replacement and eHealth contact with the healthcare providerThis study has only one arm and no comparator.
Primary Outcome Measures
NameTimeMethod
Weight loss6 months

Weight loss goal of 15 kg, measured at the research facilities

HbA1c6 months

The goal is diabetes remission with HbA1c \< 48 mmol/mol without any diabetes medication. (Secondary goal \< 42 mmol/mol.)

Secondary Outcome Measures
NameTimeMethod
Diabetes medication6 months

Change of diabetes medication during study duration

Insulin sensitivityAt baseline, 3 months and 6 months

Measured with oral glucose tolerance test

Blood pressure (systolic/diastolic)Daily measurements up to 6 months

Measured at home

Insulin secretionAt baseline, 3 months and 6 months

Measured with oral glucose tolerance test

Fasting blood glucose6 months

Partial diabetes remission (\<7.0 mol/l), complete diabetes remission (\<6.1 mol/l) without diabetes medication.

P-glucose 120 minutes after the oral glucose tolerance test6 months

Measured at the research facilities

EQ-5D-5LAt baseline, 3 months and 6 months

Questionnaire

Food frequency formAt baseline and 6 months

Questionnaire

Antidiabetic medication usage follow upYearly up to 20 years

Collected from patient journals after study completion

Blood pressure medication usage follow upYearly up to 20 years

Collected from patient journals after study completion

Semi-structured interviews6 months
Metabolic flexibilityAt baseline, 3 months and 6 months

Measured with indirect calorimetry during oral glucose tolerance test

Blood pressure medication6 months

Change of blood pressure medication during the study

Daily stepsDuring the second three months of the study

Measured with activity tracker

Diabetes complications follow upYearly up to 20 years

Collected from patient journals and registries after study completion

Body weightDaily measurements up to 6 months

Measured at home

HbA1cMonthly measurement up to 6 months

Measured at home

Blood pressure follow up (systolic/diastolic)Yearly up to 20 years

Collected from patient journals after study completion

Plasma lipid profileAt baseline, 3 months and 6 months

Measured at the research facilities

HbA1c follow upYearly up to 20 years

Collected from patient journals after study completion

Body weight follow upYearly up to 20 years

Collected from patient journals after study completion

Waist circumferenceBaseline, 3 months and 6 months

Measured in cm at the research facilities

Trial Locations

Locations (1)

Department of Public Health and Clinical Medicine, Medicine

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UmeƄ, Sweden

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