Remission of type 2 diabetes becomes possible through eHealth
Significant weight loss and remission of type 2 diabetes is possible through calorie restriction and recommended in national and international guidelines. However, sustainable weight reduction is a challenge both for the patient and the supporting healthcare provider. Therefore, diabetes remission through calorie restriction is not part of routine care. eHealth can provide a more effective, and less time consuming approach than standard care both for the patient and the healthcare provider.
In the eHealth DIabetes remission Trial (eDIT), individuals with type 2 diabetes use total diet replacement (850 kcal/day) with the goals of 15 kg weight loss and diabetes remission. Effectiveness and cost-effectiveness are compared between two randomized arms: one group has contact with the study staff only through eHealth and the other group meets the study staff face-to-face.
Head of project
Julia OttenAssistant professor, combined with clinical employment
A recent UK study shows that remission of type 2 diabetes is achievable by calorie restriction. Individuals with type 2 diabetes received total diet replacement with 850 kcal/day for 3 months and after one year 46% were in diabetes remission. According to the health economic evaluation of this study, diabetes remission with total diet replacement is cost saving after 5-6 years despite face-to-face meetings between patient and healthcare provider every 2nd to 4th week. Based on these results, calorie restriction with the goal of 15 kg weight loss and diabetes remission is now highly recommended in national and international treatment guidelines.
Face-to-face meetings every two to four weeks between patient and healthcare provider are not feasible in routine care. This is the major reason why diabetes remission by calorie restriction is not considered as therapy for patients with type 2 diabetes in Sweden today. Therefore, we have specifically developed an eHealth program for the eHealth DIabetes remission Trial (eDIT) with the aim to help patients to achieve diabetes remission through calorie restriction in a cost-effective way. Our main hypothesis is that the eHealth program is non-inferior to face-to-face meetings in respect to diabetes remission. With a health economic evaluation, we compare cost-effectiveness between study arms.
In order to understand the mechanisms behind diabetes remission, we examine resting metabolic rate, insulin sensitivity, insulin secretion, glucagon sensitivity, amino acid tolerance, postprandial incretins, lung function and adipose tissue function and secretory capacity.
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