In this study, we evaluated whether the digital program Vitadio achieves comparable results to those of an intensive in-person lifestyle intervention in obesity management. This is a 12-month prospective, randomized controlled trial. Obese patients with insulin resistance, prediabetes or type 2 diabetes were included. The intervention group (IG) used Vitadio. The control group (CG) received a series of in-person consultations. Body weight and various metabolic parameters were observed and analyzed with ANOVA. The trial is ongoing and the presented findings are preliminary. Among 100 participants (29% men; mean age, 43 years; mean BMI, 40.1 kg/m2), 78 completed 3-month follow-up, and 51 have completed the 6-month follow-up so far. Participants significantly (p < 0.01) reduced body weight at 3 months (IG: −5.9 ± 5.0%; CG: −4.2 ± 5.0%) and 6 months (IG: −6.6±6.1%; CG: −7.1 ± 7.1%), and the difference between groups was not significant. The IG achieved favorable change in body composition; significant improvement in TAG (−0.6 ± 0.9 mmol/l, p < 0.01), HDL (0.1 ± 0.1%, p < 0.05), HbA1c (−0.2 ± 0.5%, p < 0.05) and FG (−0.5 ± 1.5 mmol/l, p < 0.05); and a superior (p = 0.02) HOMA-IR reduction (−2.5 ± 5.2, p < 0.01). The digital intervention achieved comparable results to those of the intensive obesity management program. The results suggest that Vitadio is an effective tool for supporting patients in obesity management and diabetes prevention.

1st Faculty of Medicine Charles University Prague Kateřinská 32 121 08 Prague Czech Republic

Department for Prevention and Care of Diabetes Department of Medicine 3 Faculty of Medicine Carl Gustav Carus Technische Universität Dresden Fetscherstrasse 74 01307 Dresden Germany

Department of Exercise Medicine and Cardiovascular Rehabilitation University Hospital Olomouc 1 P Pavlova 6 779 00 Olomouc Czech Republic

Department of Health Faculty of Medicine Masaryk University Kamenice 5 625 00 Brno Czech Republic

MMW Fortschr Med. 2023 Jan;165(1):24-25. doi: 10.1007/s15006-023-2263-y. PubMed

Zobrazit více v PubMed

Pi-Sunyer X. The Medical Risks of Obesity. Postgrad. Med. 2009;121:21–33. doi: 10.3810/pgm.2009.11.2074. PubMed DOI PMC

Kotsis V., Martinez F., Trakatelli C., Redon J. Impact of Obesity in Kidney Diseases. Nutrients. 2021;13:4482. doi: 10.3390/nu13124482. PubMed DOI PMC

International Diabetes Federation . The IDF Consensus Worldwide Definition of Metabolic Syndrome. International Diabetes Federation; Brussels, Belgium: 2006.

Fukumoto Y. Nutrition and Cardiovascular Diseases. Nutrients. 2022;14:94. doi: 10.3390/nu14010094. PubMed DOI PMC

Tuomilehto J., Lindström J., Eriksson J.G., Valle T.T., Hämäläinen H., Ilanne-Parikka P., Keinänen-Kiukaanniemi S., Laakso M., Louheranta A., Rastas M., et al. Prevention of Type 2 Diabetes mellitus by Changes in Lifestyle among Subjects with Impaired Glucose Tolerance. N. Engl. J. Med. 2001;344:1343–1350. doi: 10.1056/NEJM200105033441801. PubMed DOI

Look AHEAD Research Group. Pi-Sunyer X., Blackburn G., Brancati F.L., Bray G.A., Bright R., Clark J.M., Curtis J.M., Espeland M.A., Foreyt J.P., et al. Reduction in Weight and Cardiovascular Disease Risk Factors in Individuals with Type 2 Diabetes: One-Year Results of the Look AHEAD Trial. Diabetes Care. 2007;30:1374–1383. doi: 10.2337/dc07-0048. PubMed DOI PMC

Chen L., Pei J.-H., Kuang J., Chen H.-M., Chen Z., Li Z.-W., Yang H.-Z. Effect of Lifestyle Intervention in Patients with Type 2 Diabetes: A Meta-Analysis. Metabolism. 2015;64:338–347. doi: 10.1016/j.metabol.2014.10.018. PubMed DOI

Rippe J.M., Crossley S., Ringer R. Obesity as a Chronic Disease: Modern Medical and Lifestyle Management. J. Am. Diet. Assoc. 1998;98:S9–S15. doi: 10.1016/S0002-8223(98)00704-4. PubMed DOI

Zhang Y., Liu J., Yao J., Ji G., Qian L., Wang J., Zhang G., Tian J., Nie Y., Zhang Y.E., et al. Obesity: Pathophysiology and Intervention. Nutrients. 2014;6:5153–5183. doi: 10.3390/nu6115153. PubMed DOI PMC

Wiechert M., Holzapfel C. Nutrition Concepts for the Treatment of Obesity in Adults. Nutrients. 2022;14:169. doi: 10.3390/nu14010169. PubMed DOI PMC

American Diabetes Association Obesity Management for the Treatment of Type 2 Diabetes. Diabetes Care. 2016;39((Suppl. S1)):S47–S51. doi: 10.2337/dc16-S009. PubMed DOI

Hassan Y., Head V., Jacob D., Bachmann M.O., Diu S., Ford J. Lifestyle Interventions for Weight Loss in Adults with Severe Obesity: A Systematic Review. Clin. Obes. 2016;6:395–403. doi: 10.1111/cob.12161. PubMed DOI

Rubio-Valera M., Pons-Vigués M., Martínez-Andrés M., Moreno-Peral P., Berenguera A., Fernández A. Barriers and Facilitators for the Implementation of Primary Prevention and Health Promotion Activities in Primary Care: A Synthesis through Meta-Ethnography. PLoS ONE. 2014;9:e89554. doi: 10.1371/journal.pone.0089554. PubMed DOI PMC

Kebbe M., Perez A., Buchholz A., McHugh T.-L.F., Scott S.S., Richard C., Mohipp C., Dyson M.P., Ball G.D.C. Barriers and Enablers for Adopting Lifestyle Behavior Changes in Adolescents with Obesity: A Multi-Centre, Qualitative Study. PLoS ONE. 2018;13:e0209219. doi: 10.1371/journal.pone.0209219. PubMed DOI PMC

Patterson E., Munn Z., Jennings C. Experiences of Providers in Delivering Nutrition-Focused Lifestyle Interventions for Adults with Obesity or Metabolic Syndrome in Primary Healthcare Settings: A Qualitative Systematic Review Protocol. JBI Evid. Synth. 2020;18:1573–1579. doi: 10.11124/JBISRIR-D-19-00182. PubMed DOI

Patalano R., De Luca V., Vogt J., Birov S., Giovannelli L., Carruba G., Pivonello C., Stroetmann V., Triassi M., Colao A., et al. An Innovative Approach to Designing Digital Health Solutions Addressing the Unmet Needs of Obese Patients in Europe. Int. J. Environ. Res. Public Health. 2021;18:E579. doi: 10.3390/ijerph18020579. PubMed DOI PMC

Dallinga J.M., Mennes M., Alpay L., Bijwaard H., Baart de la Faille-Deutekom M. App Use, Physical Activity and Healthy Lifestyle: A Cross Sectional Study. BMC Public Health. 2015;15:833. doi: 10.1186/s12889-015-2165-8. PubMed DOI PMC

Shcherbina A., Hershman S.G., Lazzeroni L., King A.C., O’Sullivan J.W., Hekler E., Moayedi Y., Pavlovic A., Waggott D., Sharma A., et al. The Effect of Digital Physical Activity Interventions on Daily Step Count: A Randomised Controlled Crossover Substudy of the MyHeart Counts Cardiovascular Health Study. Lancet Digit. Health. 2019;1:e344–e352. doi: 10.1016/S2589-7500(19)30129-3. PubMed DOI

Timpel P., Oswald S., Schwarz P.E.H., Harst L. Mapping the Evidence on the Effectiveness of Telemedicine Interventions in Diabetes, Dyslipidemia, and Hypertension: An Umbrella Review of Systematic Reviews and Meta-Analyses. J. Med. Internet Res. 2020;22:e16791. doi: 10.2196/16791. PubMed DOI PMC

Byambasuren O., Sanders S., Beller E., Glasziou P. Prescribable MHealth Apps Identified from an Overview of Systematic Reviews. NPJ Digit. Med. 2018;1:12. doi: 10.1038/s41746-018-0021-9. PubMed DOI PMC

Fleming G.A., Petrie J.R., Bergenstal R.M., Holl R.W., Peters A.L., Heinemann L. Diabetes Digital App Technology: Benefits, Challenges, and Recommendations. A Consensus Report by the European Association for the Study of Diabetes (EASD) and the American Diabetes Association (ADA) Diabetes Technology Working Group. Diabetes Care. 2020;43:250–260. doi: 10.2337/dci19-0062. PubMed DOI

Haffner S.M., Miettinen H., Stern M.P. The Homeostasis Model in the San Antonio Heart Study. Diabetes Care. 1997;20:1087–1092. doi: 10.2337/diacare.20.7.1087. PubMed DOI

Schmidt F.H. Die Enzymatische Bestimmung von Glucose Und Fructose Nebeneinander. Klin. Wochenschr. 1961;39:1244–1247. doi: 10.1007/BF01506150. PubMed DOI

Arslan Ince F.D., Atay A., Köseoğlu M., Yeşil M., Deveci E. Relationship between Severity of Coronary Artery Disease and Apolipoprotein E Gene Polymorphism. Anadolu Kardiyol. Derg. 2010;10:202–208. doi: 10.5152/akd.2010.058. PubMed DOI

Matthews D.R., Hosker J.P., Rudenski A.S., Naylor B.A., Treacher D.F., Turner R.C. Homeostasis Model Assessment: Insulin Resistance and Beta-Cell Function from Fasting Plasma Glucose and Insulin Concentrations in Man. Diabetologia. 1985;28:412–419. doi: 10.1007/BF00280883. PubMed DOI

Committee for Medicinal Products for Human Use. Efficacy Working Party Committee for Release for Consultation Committee for Medicinal Products for Human Use (CHMP) Guideline on the Choice of the Non-Inferiority Margin. Stat. Med. 2006;25:1628–1638. doi: 10.1002/sim.2584. PubMed DOI

Franz M.J., VanWormer J.J., Crain A.L., Boucher J.L., Histon T., Caplan W., Bowman J.D., Pronk N.P. Weight-Loss Outcomes: A Systematic Review and Meta-Analysis of Weight-Loss Clinical Trials with a Minimum 1-Year Follow-Up. J. Am. Diet. Assoc. 2007;107:1755–1767. doi: 10.1016/j.jada.2007.07.017. PubMed DOI

Meyerowitz-Katz G., Ravi S., Arnolda L., Feng X., Maberly G., Astell-Burt T. Rates of Attrition and Dropout in App-Based Interventions for Chronic Disease: Systematic Review and Meta-Analysis. J. Med. Internet Res. 2020;22:e20283. doi: 10.2196/20283. PubMed DOI PMC

Cheal K.L., Abbasi F., Lamendola C., McLaughlin T., Reaven G.M., Ford E.S. Relationship to Insulin Resistance of the Adult Treatment Panel III Diagnostic Criteria for Identification of the Metabolic Syndrome. Diabetes. 2004;53:1195–1200. doi: 10.2337/diabetes.53.5.1195. PubMed DOI

Spring B., Duncan J.M., Janke E.A., Kozak A.T., McFadden H.G., DeMott A., Pictor A., Epstein L.H., Siddique J., Pellegrini C.A., et al. Integrating Technology into Standard Weight Loss Treatment: A Randomized Controlled Trial. JAMA Intern. Med. 2013;173:105–111. doi: 10.1001/jamainternmed.2013.1221. PubMed DOI PMC

Ryan D.H., Yockey S.R. Weight Loss and Improvement in Comorbidity: Differences at 5%, 10%, 15%, and Over. Curr. Obes. Rep. 2017;6:187–194. doi: 10.1007/s13679-017-0262-y. PubMed DOI PMC

Willoughby D., Hewlings S., Kalman D. Body Composition Changes in Weight Loss: Strategies and Supplementation for Maintaining Lean Body Mass, a Brief Review. Nutrients. 2018;10:E1876. doi: 10.3390/nu10121876. PubMed DOI PMC

Dulloo A.G., Jacquet J., Montani J.-P. How Dieting Makes Some Fatter: From a Perspective of Human Body Composition Autoregulation. Proc. Nutr. Soc. 2012;71:379–389. doi: 10.1017/S0029665112000225. PubMed DOI

Balkau B., Picard P., Vol S., Fezeu L., Eschwège E., DESIR Study Group Consequences of Change in Waist Circumference on Cardiometabolic Risk Factors over 9 Years: Data from an Epidemiological Study on the Insulin Resistance Syndrome (DESIR) Diabetes Care. 2007;30:1901–1903. doi: 10.2337/dc06-2542. PubMed DOI

St George A., Bauman A., Johnston A., Farrell G., Chey T., George J. Effect of a Lifestyle Intervention in Patients with Abnormal Liver Enzymes and Metabolic Risk Factors. J. Gastroenterol. Hepatol. 2009;24:399–407. doi: 10.1111/j.1440-1746.2008.05694.x. PubMed DOI

Esteghamati A., Ashraf H., Esteghamati A.-R., Meysamie A., Khalilzadeh O., Nakhjavani M., Abbasi M. Optimal Threshold of Homeostasis Model Assessment for Insulin Resistance in an Iranian Population: The Implication of Metabolic Syndrome to Detect Insulin Resistance. Diabetes Res. Clin. Pract. 2009;84:279–287. doi: 10.1016/j.diabres.2009.03.005. PubMed DOI

Perrin A., Anderson M. Share of U.S. Adults Using Social Media, Including Facebook, Is Mostly Unchanged since 2018. Pew Research Center; Washington, DC, USA: 2019.

Evaluation of the Impact of Mobile Health App Vitadio in Patients With Type 2 Diabetes: Randomized Controlled Trial

Comparing the Efficacy of Digital and In-Person Weight Loss Interventions for Patients with Obesity and Glycemic Disorders: Evidence from a Randomized Non-Inferiority Trial