Active assistance technology reduces glycosylated hemoglobin and weight in individuals with type 2 diabetes: results of a theory-based randomized trial

Diabetes Technol Ther. 2013 Aug;15(8):662-9. doi: 10.1089/dia.2013.0056. Epub 2013 Jul 11.


Background: Type 2 diabetes is an individual health challenge requiring ongoing self-management. Remote patient reporting of relevant health parameters and linked automated feedback via mobile telephone have potential to strengthen self-management and improve outcomes. This research involved development and evaluation of a mobile telephone-based remote patient reporting and automated telephone feedback system, guided by health behavior change theory, aimed at improving self-management and health status in individuals with type 2 diabetes.

Subjects and methods: This research comprised a randomized controlled trial. Inclusion criteria were diagnosis of type 2 diabetes, elevated glycosylated hemoglobin (HbA1c) levels (range, 6.5-11%) or use of oral diabetes medication, and 30-70 years of age. Intervention subjects (n=24) participated in remote patient reporting of health status parameters and linked health behavior change feedback. Control participants (n=24) received standard of care including diabetes education and healthcare provider counseling. Patients were followed for approximately 10 months.

Results: Intervention participants achieved, compared with controls and controlling for baseline, a significantly greater mean reduction in HbA1c of -0.40% (95% confidence interval [CI] -0.67% to -0.14%) versus 0.036% (95% CI -0.23% to 0.30%) (P<0.03) and significantly greater weight reduction of -2.1 kg (95% CI -3.6 to -0.6 kg) versus 0.4 kg (95% CI -1.1 to 1.9 kg). Nonsignificant trends for greater intervention compared with control improvement in systolic and diastolic blood pressure were observed.

Conclusions: Sophisticated information technology platforms for remote patient reporting linked with theory-based health behavior change automated feedback have potential to improve patient outcomes in type 2 diabetes and merit scaled-up research efforts.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Body Mass Index
  • Combined Modality Therapy / instrumentation
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / therapy*
  • Feedback, Psychological*
  • Female
  • Follow-Up Studies
  • Glycated Hemoglobin A / analysis
  • Health Behavior
  • Humans
  • Hyperglycemia / prevention & control*
  • Male
  • Medical Informatics Applications
  • Middle Aged
  • Motivation
  • Obesity / blood
  • Obesity / complications
  • Obesity / therapy*
  • Overweight / blood
  • Overweight / complications
  • Overweight / therapy*
  • Psychological Theory
  • Self Care / instrumentation*
  • Telemedicine / methods*
  • Weight Loss


  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human