Efficacy of a virtual assistance‐based lifestyle intervention in reducing risk factors for Type 2 diabetes in young employees in the information technology industry in India: LIMIT, a randomized controlled trial

Aims To investigate a virtual assistance‐based lifestyle intervention to reduce risk factors for Type 2 diabetes in young employees in the information technology industry in India. Methods LIMIT (Lifestyle Modification in Information Technology) was a parallel‐group, partially blinded, randomized controlled trial. Employees in the information technology industry with ≥3 risk factors (family history of cardiometabolic disease, overweight/obesity, high blood pressure, impaired fasting glucose, hypertriglyceridaemia, high LDL cholesterol and low HDL cholesterol) from two industries were randomized to a control or an intervention (1:1) group. After initial lifestyle advice, the intervention group additionally received reinforcement through mobile phone messages (three per week) and e‐mails (two per week) for 1 year. The primary outcome was change in prevalence of overweight/obesity, analysed by intention to treat. Results Of 437 employees screened (mean age 36.2 ± 9.3 years; 74.8% men), 265 (61.0%) were eligible and randomized into control (n=132) or intervention (n=133) group. After 1 year, the prevalence of overweight/obesity reduced by 6.0% in the intervention group and increased by 6.8% in the control group (risk difference 11.2%; 95% CI 1.2–21.1; P=0.042). There were also significant improvements in lifestyle measurements, waist circumference, and total and LDL cholesterol in the intervention group. The number‐needed‐to‐treat to prevent one case of overweight/obesity in 1 year was 9 (95% CI 5–82), with an incremental cost of INR10665 (£112.30) per case treated/prevented. A total of 98% of participants found the intervention acceptable. Conclusions A virtual assistance‐based lifestyle intervention was effective, cost‐effective and acceptable in reducing risk factors for diabetes in young employees in the information technology industry, and is potentially scalable. What's new? We investigated the effectiveness of virtual assistance in reducing Type 2 diabetes risk factors in young, technology‐literate, adults with normoglycaemia who were at high risk of developing diabetes. A combination of mobile phone messages (text) and e‐mails (graphics) was used to promote healthy lifestyle behaviours. The intervention was effective, cost‐effective and acceptable in reducing overweight/obesity and other cardiometabolic risk factors at 1 year. Those who achieved a greater number of lifestyle goals experienced greater risk reduction. This approach is potentially scalabl