FROM PERSONAL DIGITAL ASSISTANT TO PERSONAL DIET ASSISTANT: STUDY EXAMINES EFFICACY OF PDA AS A DIABETES MANAGEMENT TOOL 

May 17, 2006 

WORCESTER, Ma.-The twin epidemics of obesity and diabetes are among the most pressing public health issues facing the United States.  The conditions are linked, with the dramatic increase in obesity over the past 20 years driving the rise in type 2 diabetes.  Yet, modifying eating habits is key to addressing both epidemics. Now, a team at the University of Massachusetts Medical School is publishing promising results from a pilot study that investigated the efficacy of employing PDA technology to assist diabetic patients in improving their blood sugar control by modifying their diet. 

In "PDA-Assisted Low Glycemic Index Dietary Intervention for Type 2 Diabetes: A Pilot Study," published in the May 17, 2006 advance online publication of the European Journal of Clinical Nutrition, Assistant Professor of Medicine Yunsheng Ma, MD, PhD, and Registered Dietician and Instructor in Medicine Barbara C. Olendzki, RD, MPH, and colleagues, report that study participants using the PDA technology experienced a decrease in average glycosylated hemoglobin, a measure that reflects average glycemic level during the preceding two to three months. Body weight, hip circumference, blood pressure, dietary glycemic index (GI), daily caloric intake, and diabetes impact scores also decreased after a three-month intensive intervention, and these changes were maintained during a three-month follow-up. 

The pilot study enrolled 15 people with type 2 diabetes who, in conjunction with attending counseling sessions on nutrition and eating strategies, carried PDAs with them at all times to document what they ate. This information was then downloaded and analyzed by the researchers working on the study. Much more than a recording device, the PDA's database and user interface offered participants instant access to nutritional information on the foods they'd chosen to eat, and when appropriate, prompted them to consider alternative food choices that were better for their diet. 

That diet, developed by Ma and colleagues, built upon a nutritional strategy to lower the GI of the participants' overall food intake. The GI is a measure of how much and how fast a food raises blood sugar levels. Foods with a high GI value such as potatoes, refined grains, pasta and overly processed breads rapidly spike blood sugar, while foods with a low GI value such as beans, whole wheat pasta, apples and leafy green vegetables can help control blood sugar levels. By lowering the GI of people's diet, the scientists postulated, the sugar/insulin reactions would be attenuated, improving blood sugar control and reducing the patients' need for medication. 

"A low GI diet influences insulin levels, hunger and metabolism, and therefore may help prevent overeating," said Olendzki. "Our ultimate goal is to use this leading-edge technology to improve public health by targeting both diabetes and obesity." 

To that end, according to Ma, the study provides encouraging data regarding the feasibility of a nutritionist-delivered low-GI intervention, assisted by a PDA food database. "We look forward to implementing a more in-depth study to further explore the impact of a PDA-assisted low-GI intervention on glycemic control in type 2 diabetes in a more diverse population." 

In addition to a larger effectiveness study, Ma and colleagues look forward to enhancing the PDA technology with improvements to facilitate and simplify the user experience. The PDA development would include expansion of the database to increase patient satisfaction with their ability to obtain information on common foods, and an automated and personalized feedback system, in as close to real time as possible. 

The University of Massachusetts Medical School, one of the fastest growing academic health centers in the country, has built a reputation as a world-class research institution, consistently producing noteworthy advances in clinical and basic research.  The Medical School attracts more than $174 million in research funding annually, 80 percent of which comes from federal funding sources. UMMS is the academic partner of UMass Memorial Health Care, the largest health care provider in Central Massachusetts. For more information visit www.umassmed.edu 

Contact: Kelly Bishop
508.856.2000
ummsnews@umassmed.edu