Digital Nutrition Counseling and its Impact on Diabetics and Prediabetic Individuals in the Developing Country

Abstract

Digital health care services claim to assist personalised patient care. Web-based programs and apps are relatively low-cost with the potential for broad reach. Digital nutrition therapy that monitors or provides recommendations on diet is effective in managing Diabetes. However, there is less evidence on how the integration of personalized nutrition recommendations impacts glycemic control among individuals with diabetes and prediabetes. The objective of the study is to assess the quality and effectiveness of the Mfine Diabetes care program in improving glycaemic levels among diabetes and prediabetes individuals. One hundred and seventy-two adults: 112 males and 60 females (mean age 48.1±12.3) with Type II diabetes and prediabetes who enrolled and completed 3 three-month paid diabetes care programs through MFine application between November 2021 to December 2022 were included. User characteristics and their associations with diabetes management were analysed retrospectively. Information regarding the participant’s age, gender, height, weight, comorbidities or history of illness, medication details with dosage and usual dietary intake were collected. Participants who followed the program were compared to their baseline measures taken before the intervention, to assess any improvement or decline in the lab values (Hb_A1c, FBS, ABG), and diabetic medication post-program completion. The before-after lab test design was used to evaluate changes in outcomes over time. The mean BMI of the study group was 28.6±2.9 kg/m². Of them 138 patients were diabetic with (mean initial Hb_A1c 8.96±1.93, FBS 179.7±67, and ABG 186.1±61.0 mg/dl) and 34 patients were prediabetic individuals with (mean initial HbA1, 6.27±0.13, FBS 154.1±54.1 mg/dl, and ABG 172.5±49.9) at initial consultation. After following program for 3 months with therapeutic carbohydrate restriction/four pillars consideration (Diet, physical activity, sleep and stress management) there was a significant difference (p<0.000) among the participants with final blood glucose levels of diabetic (mean final Hb_A1c 6.48±0.72, FBS 122.2±30.1, and ABG 130.4±32.0) and prediabetic individuals (mean final HbA1, 5.25±0.24, FBS 102.7±14.5 mg/dl, and ABG 116.2±20.3 mg/dl). Also, there was a change in medication dosage among this population (36% of individuals have been recommended to reduce the medication dosage, and 26% of individuals were advised to stop medication upon carbohydrate restriction) post-program completion. Digital nutrition counselling and monitoring interventions with Mfine application targeting prediabetes and Type II diabetes are effective for improving glycaemic levels (Hb_A1c, FBS, ABG). There was a significant improvement in their glycemic levels and a decrease in body weight and BMI. Thus, this digital therapeutic program can be considered an effective tool for improving glycaemic control in people with diabetes and pre-diabetes individuals.