Around two decades ago, the Finnish Diabetes Prevention Study provided evidence that personalized interventions targeting nutrition and physical activity could decrease the occurrence of type 2 diabetes mellitus (T2DM) in a high-risk population. In recent times, the utilization of digital applications for healthcare delivery has exhibited positive outcomes on health and nutrition, including the enhancement of glucose metabolism. A recently conducted randomized controlled trial (RCT), comparing digital Diabetes Prevention Program (DPP) with small-group sessions, concluded that the former was more effective in preventing T2DM. However, there remains a gap in our understanding regarding whether combining digital and face-to-face interventions yields superior results compared to utilizing each approach separately. The gap in our knowledge is whether the combination of digital and face-to-face interventions is more effective than each one in isolation.
This real-world randomised controlled trial (RCT), again from Finland, examined the effectiveness of combined digital and group-based face-to-face delivery of lifestyle interventions to address risk factors for the development of T2DM in an at-risk population. In The Lancet Regional Health – Europe, Lakka et al report the findings of their trial, which was a one-year, multi-centre, unblinded, pragmatic RCT conducted in Finnish primary healthcare in adult patients at increased risk of type 2 diabetes mellitus. 2907 patients, 80% of which were women and with a mean body mass index 31.1 ± 5.4 kg/m2 were randomised into a digital lifestyle intervention group (n = 967), a combined digital and group-based lifestyle intervention group (n = 971) and a control group (n = 969) receiving usual care.
The multifactorial interventions were not focused on weight loss but on changes in daily habits using three predefined theories – the self-determination theory promoting motivation to change habits that you have personally chosen (i.e., autonomy)self-regulation theory promoting self-monitoring, goal setting and action planning, and habit formation, which enables healthier habitual behaviour through regular repetition. The face-to-face intervention was a six-session group coaching programme.