A retrospective analysis of more than 2,000 Livongo Diabetes Prevention Program (DPP) participants found an average weight loss of 5.1% from baseline after 12 months, and 6.6% among those who designated as high engagers.
The study, conducted by Livongo and published in BMJ Open Diabetes Research & Care, honed in on the relationships between specific program behaviors and program engagement with weight-loss outcomes.
"Understanding the behaviors and specific program components that are associated with greater weight loss in a technology-based diabetes prevention program can influence best practices for program creation and coaching to improve outcomes and decrease participants’ risk factors for developing Type 2 diabetes," the researchers wrote.
Among the 2,037 participants included in the final analysis, 32.3% (n = 658) completed enough lessons to meet the CDC criteria of high engagement. About 97% of these users registered a 12-month weight loss, versus just over half of the remaining participants.
Forty-three percent of the full cohort lost the average 5.1% of their baseline weight by 12 months, with weight loss of 5% or above more prevalent among those who were highly engaged with Livongo's DPP (50% of high engagers versus 35% of minimal engagers). A quarter of the high engagers also recorded 12-month weight loss of 10% or more.
Further analysis of the participants found food logging through Livongo's digital tool to be the greatest predictor of weight loss, followed by lesson completion and physical activity. High engagement was also tied to more frequent use of an activity tracker and a digital scale.
Although text-based coaching delivered through the program was not found to be a direct predictor of weight loss, it was associated with more frequent food logging, weigh-ins and physical activity.
HOW IT WAS DONE
Researchers looked back at data logged by individuals who were enrolled in Livongo DPP through an employer-sponsored program between May 2016 and September 2017. All participants completed the program's first lesson and logged a starting weight.
The Livongo DPP consisted of 31 interactive digital lessons that emphasize self-monitoring practices. Along with the app that delivers these lessons, informational content, a moderated online community and virtual coaching, the participants are provided a wireless Bluetooth scale and a web-based dashboard. Participants may also choose to connect a fitness-tracking device.
The researchers collected and analyzed weigh-ins at six and 12 months, and reviewed program participation data to identify links between behaviors and weight loss outcomes. High engagement was defined by CDC's existing criteria for DPPs: completion of nine lessons within the first six months and three lessons within the second six months, with a minimum of nine months between completion of the first and final lessons.
WHAT'S THE HISTORY?
While Livongo has been offering its DPP for some time, the program was only recognized by the CDC and listed in its online referral tool in late 2018. Recent years, however, have seen the company branch out from diabetes management into a handful of other chronic-health needs, such as hypertension and behavioral health.
ON THE RECORD
"As this study of people living with pre-diabetes reveals, the opportunities for improvement are significant and the stakes are very high," Dr. Bimal Shah, chief medical officer at Livongo, wrote in a blog post outlining the study. "By making it easier for people to make the right decisions every day and sustain them over time, we can help millions who are at-risk today reverse course and live healthier lives tomorrow."