This study will serve as a basis for preparing a future clinical trial aimed at comparing what works better: (i) delivering economic incentives to the individual with diabetes (individual incentives) or (ii) delivering incentives to the patient and a companion, a person who motivates and helps the patient in changing their habits to control their diabetes and improve their health (mixed incentives).

Aim:

This exploratory project aims to determine whether using economic incentives can promote habits that result in weight reduction and better glycaemic control in patients with diabetes.

Study design:

The project consists of three phases:

Phase 1: Formative Study

Through questionnaires (stage 1) and in-depth interviews (stage 2) with patients with diabetes and their family members, we will seek to answer the following questions: What should be the amount of the economic incentive to promote weight loss and better disease control in patients with type 2 diabetes mellitus? What is the best way to deliver this incentive? How do patients perceive the weight reduction goals proposed to them? What is the profile of the companions, and what is their role in managing the patient’s condition?

Phase 2: Pilot Study

In this stage, 54 patients will be randomised (18 in each arm) to compare the effect of individual and mixed economic incentives on weight reduction and glycosylated haemoglobin in patients with type 2 diabetes mellitus. This stage will also evaluate the process of implementing this strategy, rescuing lessons useful for implementing a clinical trial.

Phase 3:  In this stage, the participant’s experience in the pilot study will be evaluated through in-depth interviews with patients and their family members.

Since any intervention must have long-term results, this study will additionally seek to determine mortality and morbidity in different patients with diabetes (from the general population and those in treatment) to generate the necessary assumptions for estimating the sample size of a future study.

Result:

Out of 783 patients screened, a total of 54 participants, 18 per study arm, were enrolled and 44 (82%) completed the 3-month follow-up. Mean baseline HbA1c values were 8.5%, 7.9% and 8.2% in Arm 1, Arm 2, and Arm 3, respectively. At 3 months, participants in all three study arms showed reductions in HbA1c ranging from -0.9% in Arm 2 to -1.4% in Arm 1. Weight and BMI also showed reductions.

Contact:

María Amalia Pesantes, MA, MPH, PhD
maria.pesantes.v@upch.pe