News in brief: Gamification nudges T2D patients into activity; Rebound fractures assessed after denosumab; CSII reduces diabetic retinopathy progression

Tuesday, 25 May 2021

Gamification nudges T2D patients into activity

A gamification intervention can ‘nudge’ people with type 2 diabetes into making long term lifestyle changes to reduce their risk profile, a study shows.

Higher levels of physical activity were seen for 361 overweight adults with T2D who were entered into a one-year ‘game’ that provided them with points and levels for achieving step goals and weight loss targets.

Compared with the control group, the diabetes ‘lifestyle gamers’ did  about 600 more steps per day over the one year intervention period if they had supports with greater results with a competition element compared to a ‘collaborative’ mode of  gaming.

All groups in the trial showed significant reductions in weight and HbA1c levels from baseline, but there were no significant differences between any of the intervention arms and the control arm, according to researchers from the University of Pennsylvania.

More information: JAMA Network Open.

Risk of rebound fractures defined after stopping denosumab

The risk of  rebound vertebral fractures after discontinutation of denosumab is  is poorly predictable before the start of therapy, a Swiss study has shown. But there is significant predictive value from bone resorption markers and low total hip BMD during and after treatment, according to data derived from 797 female patients who received an average of six injections of denosumab over three years.

The vertebral fracture risk in the two years after denosumab discontinuation was close to 10% and was increased in patients who experienced non-vertebral fractures, the study showed. Bisphosphonates given after denosumab treatment decreased vertebral fracture risk, but bisphosphonates given before denosumab did not provide an additional benefit.

The findings are published in the Journal of Bone and Mineral Research

CSII reduces diabetic retinopathy progression compared with MDI therapy

Continuous subcutaneous insulin infusion therapy (CSII) is associated with reduced retinopathy progression compared with multiple daily injections (MDI) of insulin, a UK study has shown.

A retrospective cohort study examined retinal screening outcomes and HbA1c changes over three years in 204 adults who commenced on CSII therapy and a control group of 211 adults eligible for CSII who continued on MDI therapy.

There was a larger reduction in HbA1c at one year in those on CSII vs MDI (−6  vs −2 mmol/mol). Diabetic retinopathy progression occurred in a smaller proportion of adults following commencement of CSII vs continued MDI therapy over mean 2.3 year follow-up (26.5% vs 18.6%). Progression of diabetic retinopathy over three years was not associated with a change in HbA1c.

The findings are published in Diabetologia.

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