Effects of a three-armed randomised controlled trial using self-monitoring of daily steps with and without counselling in prediabetes and type 2 diabetes-the Sophia Step Study

Jenny Rossen, Kristina Larsson, Maria Hagströmer, Agneta Yngve, Kerstin Brismar, Barbara Ainsworth, Linda Åberg, Unn-Britt Johansson, Jenny Rossen, Kristina Larsson, Maria Hagströmer, Agneta Yngve, Kerstin Brismar, Barbara Ainsworth, Linda Åberg, Unn-Britt Johansson

Abstract

Background: This aimed to evaluate the effects of self-monitoring of daily steps with or without counselling support on HbA1c, other cardiometabolic risk factors and objectively measured physical activity (PA) during a 2-year intervention in a population with prediabetes or type 2 diabetes.

Methods: The Sophia Step Study was a three-armed parallel randomised controlled trial. Participants with prediabetes or type 2 diabetes were recruited in a primary care setting. Allocation (1:1:1) was made to a multi-component intervention (self-monitoring of steps with counselling support), a single-component intervention (self-monitoring of steps without counselling support) or standard care. Data were collected for primary outcome HbA1c at baseline and month 6, 12, 18 and 24. Physical activity was assessed as an intermediate outcome by accelerometer (ActiGraph GT1M) for 1 week at baseline and the 6-, 12-, 18- and 24-month follow-up visits. The intervention effects were evaluated by a robust linear mixed model.

Results: In total, 188 subjects (64, 59, 65 in each group) were included. The mean (SD) age was 64 (7.7) years, BMI was 30.0 (4.4) kg/m2 and HbA1c was 50 (11) mmol/mol, 21% had prediabetes and 40% were female. The dropout rate was 11% at 24 months. Effect size (CI) for the primary outcome (HbA1c) ranged from -1.3 (-4.8 to 2.2) to 1.1 (-2.4 to 4.6) mmol/mol for the multi-component vs control group and from 0.3 (-3.3 to 3.9) to 3.1 (-0.5 to 6.7) mmol/mol for the single-component vs control group. Effect size (CI) for moderate-to-vigorous physical activity ranged from 8.0 (0.4 to 15.7) to 11.1 (3.3 to 19.0) min/day for the multi-component vs control group and from 7.6 (-0.4 to 15.6) to 9.4 (1.4 to 17.4) min/day for the single-component group vs control group.

Conclusion: This 2-year intervention, including self-monitoring of steps with or without counselling, prevented a decrease in PA but did not provide evidence for improved metabolic control and cardiometabolic risk factors in a population with prediabetes or type 2 diabetes.

Trial registration: ClinicalTrials.gov, NCT02374788 . Registered 2 March 2015-Retrospectively registered.

Keywords: Activity tracker; Behaviour; Cardiometabolic risk factors; HbA1c; Pedometer; Physical activity; Step counter.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2021. The Author(s).

Figures

Fig. 1
Fig. 1
Flowchart of enrollment and participation in the Sophia Step Study. Clinical presents number participants with valid data for HbA1c, Anthr = Anthropometrics presents number participants with valid data for weight, PA = Physical activity presents number participants with valid data for moderate-to-vigorous physical activity
Fig. 2
Fig. 2
Changes in HbA1c over time. Values are based on predicted group means from the linear mixed model analysis
Fig. 3
Fig. 3
Changes in physical activity over time. MVPA = Time in moderate-to-vigorous physical activity. Values are based on predicted group means from the linear mixed model analysis

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