DiaMester – An e-health lifestyle program for improved self-management and remission of type 2 diabetes
Background: Recent evidence suggest that type 2 diabetes (T2D) may be preventable and reversible if intensified lifestyle measures are implemented successfully. However, limited resources are allocated to preventive initiatives in primary care in Norway. Emerging evidence demonstrates the benefit of telemedicine and internet-based services for diabetes prevention and the management of T2D.
Aim: In close collaboration with people with T2D, Primary health care and the health-tech industry we have develop an effective, comprehensive and secure e-health program to guide and support people with T2D to obtain a healthy lifestyle and weight, ensuring secure and easy communication between participants in the program and digital coaches. We will perform a randomized controlled trial of lifestyle intervention with or without support of the e-health program to assess whether the program can induce remission of T2D and improve self-management and metabolic control.
Primary Investigator
Anne-Marie Aas, Clinical dietitian and Associate professor, Oslo University hospital and University of Oslo
Co-investigators/participants
Kåre I. Birkeland
Line Wisting
Kirsti Bjerkan
Elisabeth Qvigstad
External collaborators
University of Tromsø: Professor Eirik Årsand, Researcher Tina Rishaug, Professor Gunnar Hartvigsen, Associate Professor André Henriksen
Abel Technologies AS: Simon Laugsand, Rolf-Harald Haugen, Håkon Laugsand
The Norwegian Diabetes Association: Ragnhild Gjevre
University of Oslo, Department of Nutrition: Associate Professor Monica Hauger Carlsen
OsloMet: Professor Milada Cvancarova Småstuen, Statistician
Municipal health services: Dietitian Cathrine Borchsenius (Bærum Municipality) and GP Ståle Sagabråten (Nesbyen M.).
Scientific advisor: Professor Michael Lean, University of Glasgow, UK
News from 2024
An article on a qualitative pre-study where we have investigated user needs and preferences for an e-health program through focus group interviews with patients with T2D, has been accepted for publication. The results were also presented at the ATTD conference 2024 and at the Diabetes and Nutrition Study Group of the EASD’s yearly symposium in June 2024.
We have received funding from the DAM foundation (October) for phd-postion for three years. We will use this to run a pilot RCT to test the feasibility of the program and to investigate to what extend the program contributes to the intended lifestyle changes, weight loss and improved QoL. Starting second half of 2025, we will randomize 99 patients with T2D to two intervention groups using the e-health program with or without a low calorie diet (LCD), and one control arm receiving usual care. Outcome data is assessed at baseline, 3 and 12 months with register-based assessment, questionnaires, and activity measurements. Patient-generated health data and feedback will be used to assess the use and acceptability of the program and to identify the parts that improve outcomes most effectively. We have been and will continue seeking further funding to test the program in a fully powered RCT aimed at remission of T2D.
Our industry partner Abel Technologies has already developed a mobile application for lifestyle intervention and digital follow-up in general, and our technical research partner at the University of Tromsø has experience from designing several health apps, whereof the previous “Diabetes Diary” app is strongly related to our aims in this project.
Based on previous diabetes and self-management studies from our project group, and results from the user preference pre-study, the e-health program will include:
An educational digital course module that can be tailored to the users’ individual needs and interactive webinars accessible through the program, hosted by health specialists.
Individual digital coaching by trained health care personnel through video conference tools, chat, and phone.
A mobile phone-based motivational self-management app. This app will offer the user relevant data and information from sensors and devices according to the users’ needs and preferences (physical activity and sleep sensors, weight scales, blood glucose monitors, etc.), as well as easy ways for recording dietary intake, and other parameters.
Publications 2024
Rishaug T, Aas AM, Henriksen A, Hartvigsen G, Birkeland KI, Årsand E. What are end-users’ needs and preferences for a comprehensive e-health program for type 2 diabetes? – A qualitative user preference study. Accepted for publication in Plos One February 7th 2025
Other scientific or public outreach activities
In recent years, I have worked on revising Norwegian guidelines for lifestyle in diabetes (Directorate of Health) and developed a guidance tool on diet and T2D, that we plan to use in DiaMester, together with Kirsti Bjerkan and the Norwegian Directorate of Health.
Invited talks:
21.mars; the Danish Diabetes and Endocrine Academy, Århus: New European recommendations for the dietary management of diabetes – what is new?
3. /17.September; Diabetesforbundet – webinar for health care providers/ members: Diabetes remission by lifestyle intervention/ The new dietary advice
23 October: Primary Care Week in Oslo, diabetes course 2024: Dietary recommendations for prevention and treatment of diabetes