March 08, 2023
2 min learn
Bonaca MP, et al. Abstracts 1350-186. Introduced at: American School of Cardiology Scientific Session; March 4-6, 2023; New Orleans (hybrid assembly).
Disclosures: The research was funded by Higher Therapeutics. Bonaca studies varied monetary ties to trade, together with receiving analysis grants from Higher Therapeutics.
NEW ORLEANS — With the usage of cognitive behavioral remedy, a smartphone app helped sufferers with kind 2 diabetes scale back HbA1c with much less treatment and insulation intensification vs. controls, a speaker reported.
“Cardiometabolic ailments, and at its core, kind 2 diabetes, are largely behavioral-acquired ailments they usually’re associated to unhelpful behaviors. However after we drive to what’s the core, the foundation causes of those behavioral selections, they need to do with ideas and beliefs that result in unhelpful behaviors after which unhelpful meals selections, consuming, train or behaviors after which kind 2 diabetes,” Marc P. Bonaca, MD, MPH, FAHA, FACC, govt director of CPC Medical Analysis, professor of cardiology and vascular medication and director of vascular analysis on the College of Colorado Faculty of Drugs, mentioned throughout a press convention. “How will we break that cycle?
“There’s really a well-established mechanism referred to as cognitive behavioral remedy. It has been round for a really very long time, proven to be efficacious for a lot of completely different circumstances, addictions, ache administration and others in addition to kind 2 diabetes,” Bonaca mentioned. “The primary subject although with cognitive behavioral remedy isn’t scalable. It is onerous. You want a therapist, you’ll want to drive into an establishment and so forth. The notion right here is are you able to develop a digital therapeutic (that) supplies cognitive behavioral remedy for sufferers with kind 2 diabetes to reverse a root trigger?”
The pivotal trial of the BT-001 cellular app (Higher Therapeutics) was a randomized managed research that enrolled 669 sufferers with diabetes at 12 websites (imply age, 58 years; imply BMI, 35 kg/m2; 56% ladies; 55% white). Individuals have been randomly assigned to an intervention app or a management app on prime of normal diabetes care.
Marc P. Bonaca, MD, MPH, FAHA, FACC
These assigned to the cognitive behavioral remedy app have been requested to finish no less than one lesson per week that goals at talent growth and habits change.
The first efficacy final result was change in imply HbA1c at 90 days. The principal security final result was antagonistic occasions. Secondary outcomes included change in HbA1c and antagonistic occasions at 180 days.
In contrast with controls, sufferers assigned to the cognitive behavioral remedy with the intervention app skilled reductions in HbA1c at each 90 days (imply distinction in change, 0.4%; P < .0001) and 180 days (imply distinction in change, 0.3%; P < .01).
The proportion of sufferers with a discount in HbA1c of 0.4% or extra at 180 days was 50% within the intervention arm in contrast with 34% within the management arm (P < .0001).
As well as, the intervention arm had much less antihyperglycemic drug intensification from baseline to exit go to in contrast with the management arm (24.4% vs. 14.4%; P < .01), and the intervention arm was much less prone to begin or improve the dose of insulin (3.8% vs. 1.5%; P < .05) and extra prone to cease or lower dose of insulin (–0.9% vs. –2.2%; P < .05), Bonaca mentioned.
“In comparison with a management app, cognitive behavioral remedy delivered with a digital cellular app or digital therapeutic not solely lowered HbA1c, but it surely did so require much less intensification of antihyperglycemic remedy, much less requirement of insulin intensification, and considerably and persistently lowered HbA1c,” Bonaca mentioned.