美国国家公共电台 NPR This Chef Lost 50 Pounds And Reversed Prediabetes With A Digital Program（在线收听）

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Medical researchers are hoping that a smartphone can help to prevent Type 2 diabetes. A program that helps people is delivered by phone. And NPR's Allison Aubrey reports on how it works.

ALLISON AUBREY, BYLINE: Sometimes a good motivation for change is fear. Don Speranza knows this. About a year ago, he heard from his doctor with some test results.

DON SPERANZA: She sent me an email that was like a gut punch.

AUBREY: Based on his weight, which had crept up to 210 pounds, and his bloodwork, he had pre-diabetes. This means his blood sugar was elevated but not yet high enough to be diagnosed with the condition.

SPERANZA: It was a real come-to-Jesus meeting for me. I mean, I was really sick to my stomach.

AUBREY: So here's what he had to get his head around. If he could lose weight, a significant amount, he could get his blood sugar back in the normal range and fend off the disease. Mark Greenwood, a physician with Intermountain Healthcare, says when people change their habits, it can be transformative.

MARK GREENWOOD: You can either delay or, in some cases, prevent diabetes. And both are, of course, victories, if you will.

AUBREY: So how can a smartphone help people pull this off? Well, studies show that in order to make big changes - to lose 5 to 7 percent of your body weight - people need help. They need education and counseling, typically offered in a class setting or a doctor's office. They also need a coach and peer support. But Don Speranza had access to none of this. He lives on a farm along the Columbia River in Washington. He runs a small B&B, and he's the chef there. The closest city is an hour away, so it would not be easy to go to a class.

SPERANZA: Yeah, I was kind of lost as to what to do. I knew I needed to do something.

AUBREY: So, through his doctor, he signed up for a digital program designed by Omada Health. It offers all the components of lifestyle change, online and electronically. The first thing that happened, Omada sent him a digital scale. Each day, he'd weigh himself and upload the data to a dashboard. He used a wearable device to track his exercise. He also documented what he ate. The program also provides an online coach who he could text back and forth with. She could see all of his data and give him advice.

SPERANZA: Oh, my coach, I can't sing her praises enough - what a cheerleader she was.

AUBREY: Even though they never met in person, they bonded. He took her advice. He realized, for instance, that he ate way too much of the wrong things.

SPERANZA: The homemade breads and croissants and pizza.

AUBREY: He loves these things, but he had to change his relationship with all these foods. Temporarily, he cut out all those refined carbohydrates and trained himself not to eat all the treats he bakes for his guests. And he began to fill his plate with more protein and vegetables.

SPERANZA: Week by week, kind of one or two little changes at a time. That was a game changer.

AUBREY: The weight began to fall off. And he started to move more. His coach nudged him to switch up his morning routine.

SPERANZA: I'll start the coffee, but I'll go outside and I'll walk for 2,000 steps before I have my coffee.

AUBREY: Two thousand steps became 4,000, and he added in a daily bike ride. Now he has lost 50 pounds, and his blood sugar has returned to normal. He no longer has pre-diabetes.

SPERANZA: Oh, my gosh. You know, I'd buy flour by the 50-pound sacks. And I look at that, and I'm aghast to think that's what I was carrying around.

AUBREY: Speranza is not alone. Of the 200 people enrolled in a pilot study with Intermountain Healthcare, about 75 percent completed Omada's digital program and lost at least 5 percent of their body weight.

GREENWOOD: Honestly, this has been one of the most exciting things to me in my practice of medicine in the last few years.

AUBREY: That's Intermountain's Mark Greenwood.

GREENWOOD: When you give people tools and help instead of just preaching to them, people respond.

AUBREY: An estimated 84 million adults in the U.S. have pre-diabetes, so there are plenty of people who may also benefit from programs like this one. Allison Aubrey, NPR News.