title: Evaluating the feasibility and impact of an internet-based lifestyle management program in a diabetes care setting.
abstract: 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.
  
  
  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.
authors.affiliation: 1 Faculty of Health Sciences, McMaster University , Hamilton, Ontario, Canada .
authors.forename: Diana
authors.initials: D
authors.lastname: Sherifali
authors.forename: Rachel
authors.initials: R
authors.lastname: Hess
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: McTigue
authors.forename: Anka
authors.initials: A
authors.lastname: Brozic
authors.forename: Kester
authors.initials: K
authors.lastname: Ng
authors.forename: Hertzel
authors.initials: H
authors.lastname: Gerstein
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D003194:Computer-Assisted Instruction / Q000706:statistics & numerical data*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000523:psychology / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000517:prevention & control* / Q000523:psychology; D010349:Patient Compliance; D010865:Pilot Projects; D040242:Risk Reduction Behavior; D012648:Self Care; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human