Evaluating the feasibility and impact of an internet-based lifestyle management program in a diabetes care setting.

Background: This study determined the impact of an online lifestyle management program on obese individuals with type 2 diabetes in a large academic diabetes clinic. Subjects and Methods: Using a single cohort design, individuals with type 2 diabetes and a body mass index (BMI) of >= 30 kg/m(2) were recruited to have access to the Virtual Lifestyle Management (VLM) program for 1 year, in addition to their routine care. Participants were assessed at baseline and at 6 and 12 months for the following outcomes: (a) glycated hemoglobin (A1C), (b) lipids (total cholesterol [TC] and TC/high-density lipid [HDL] ratio), (c) weight, (d) BMI, and (e) body fat percentage (BFP). Results: Seventy-eight individuals consented to the study, 66 (84%) logged onto the system two or more times, and 49 (62%) contributed data at the 1-year program. At baseline, the mean age of participants was 57.9 years of age, and 52% were female. At 12 months, mean differences from baseline were as follows: A1C, -0.3% (95% confidence interval [CI] -0.1, -0.5; P < 0.05); TC/HDL, -0.2 (95% CI -0.01, -0.04; P < 0.05); weight, -8.6 pounds (95% CI -3.7, -13.6; P < 0.05); BMI, -1.5 kg/m(2) (95% CI -0.7, -2.3; P < 0.05); and BFP, -1.8% (95% CI -0.9, -2.7; P < 0.05). After adjusting for program use, age, and sex, changes in BMI, BFP, and self-reported daily steps taken were statistically significant at 12 months. Conclusions: This before-after pilot study demonstrates that adding an Internet-based lifestyle modification program to usual care may improve clinically important outcomes.