507-P: Effectiveness of a Ketogenic Diet and Virtual Coaching Intervention for Patients with Diabetes: A Difference-in-Differences Analysis

Autor:	Nambi J. Ndugga, Paul R. Conlin, Austin B. Frakt, Jessica Lum, Steven D. Pizer, Anne Utech, Kiersten L. Strombotne
Rok vydání:	2021
Předmět:	Research design medicine.medical_specialty business.industry Endocrinology Diabetes and Metabolism Emergency department Overweight medicine.disease Coaching Diabetes mellitus Health care Internal Medicine medicine Physical therapy medicine.symptom business Body mass index Veterans Affairs
Zdroj:	Diabetes. 70
ISSN:	1939-327X 0012-1797
Popis:	Objective: Nutrition interventions are key components of diabetes care. In light of increased disease prevalence among Veterans, the Veterans Health Administration (VA) partnered with Virta Health to test the effectiveness of a ketogenic-diet and virtual coaching intervention in controlling markers of diabetes care and healthcare utilization. Research Design and Methods: Using a difference-in-differences analysis with a waitlist-control group—a quasi-experimental methodology—we estimated the five-month change in hemoglobin A1c (HbA1c), body mass index, blood pressure, prescription medication use, and healthcare utilization. The analysis included 590 patients with diabetes who were also overweight or obese, and who regularly utilize VA for healthcare. We used data from VA electronic health records from 2018-2020. Results: The ketogenic diet and virtual coaching intervention was associated with significant reductions in HbA1c levels (-0.68, [95% CI -1.01, -0.35]), diabetes medication fills (-0.38, [-0.49, -0.26]), body mass index (-1.08, [-1.96, -0.20]), diastolic blood pressure levels (-1.4, [-2.73, -0.14]) and outpatient visits (-0.36, [-0.70, -0.02]). We found no significant change in emergency department visits. Conclusions: This real-world assessment of a virtual coaching and diet program shows that such an intervention offers short-term benefits on markers of diabetes care and healthcare utilization in patients with diabetes. It remains unclear whether the effect of the program operates primarily through the personalized coaching component, the ketogenic diet recommendations, or some combination of the two. Disclosure K. Strombotne: None. J. Lum: None. N. Ndugga: None. A. Utech: None. S. Pizer: None. A. Frakt: None. P. Conlin: None. Funding U.S. Department of Veterans Affairs (HSR&D SDR 20-386); National Institute of Diabetes and Digestive and Kidney Diseases (R01DK114098)
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::172ad5082fe5e10d4bbafb188359ca6e https://doi.org/10.2337/db21-507-p Zobrazit plný text záznamu