Digitally-Enabled Weight Management Program on T2DM

Inclusion criteria

• Have a clinical diagnosis of T2DM within the last 6 years
• Aged 20 - 70 years
• Have a BMI ≥ 27 kg/m2
• HbA1c ≥ 48 mmol/mol (≥ 42mmol/mol if prescribed glucose-lowering agents)
• Have access to the internet and a computer, smartphone or tablet
• Ability to read and understand English
• Willing to provide individual consent

Exclusion criteria

• Current insulin use
• More than two anti-hyperglycemic agents prescribed
• Recent routine HbA1c ≥ 90 mmol/mol
• Diagnosed with moderate or severe frailty
• Diagnosed eating disorder or purging
• Unable or unwilling to tolerate soy/milk-based meal replacements
• Myocardial infarction within last 6 months
• Recent eGFR <30 ml/min/1.73 m2
• Prescribed SGLT2 inhibitor for diabetic kidney disease (DKD) or left ventricular hypertrophy (LVH)
• Severe heart failure defined as equivalent to the New York Heart Association grade 3 (NYHA)
• Current treatment with anti-obesity drugs
• Learning difficulties that would prevent engagement with the program
• Having required hospitalization for depression or being prescribed antipsychotic drugs
• Known cancer
• Active substance misuse
• Contraindications to exercise
• Contraindications to lose weight
• Mental or physical incapacity that makes self-management inappropriate
• Pregnant, planning a pregnancy or lactating
• Currently undergoing palliative care
• Previous bariatric surgery or on waiting list for bariatric surgery (unless willing to come off waiting list)
• Unable to commit to long term lifestyle change
• Known proliferative retinopathy that has not been treated