Mobile application-based lifestyle intervention for improving glycemic control and body composition in manufacturing company employees in South Korea.

Abstract

Background: Workplace environments play a significant role in the development of chronic metabolic disorders. In this study, we evaluated the effectiveness of a mobile application-assisted lifestyle intervention integrated with continuous glucose monitoring (CGM) in improving glycemic control and body composition among employees of manufacturing companies and explored key predictors of intervention responsiveness.

Methods: A prospective cohort study was conducted involving 344 employees from two manufacturing companies in South Korea. Participants underwent a 12-week intervention that included individualized coaching through a mobile application and structured behavioral support, with the first 2 weeks involving real-time glucose monitoring. The primary outcomes included changes in glycated hemoglobin (HbA1c) and body mass index (BMI). Secondary outcomes were body composition parameters and CGM-derived glycemic variability indices, including spike count, average real variability (ARV), and frequency strength variability (FSV). Logistic regression analysis was conducted to identify key predictors of intervention effectiveness.

Results: After 12 weeks, HbA1c, BMI, body weight, and body fat mass significantly reduced. In addition, the muscle-to-fat ratio significantly increased. Participants with baseline HbA1c ≥ 6.5% showed greater improvements in HbA1c (7.2→6.8%, p < 0.001) than those with HbA1c < 6.5%. Similarly, the high BMI subgroup (≥ 25 kg/m²) exhibited significant improvements in BMI (27.6 to 27.0 kg/m², p < 0.001). Early CGM data indicated significant reductions in spike count (p = 0.046), ARV (p = 0.001), and FSV (p = 0.031). Lower baseline FSV indicated greater HbA1c improvement (adjusted odds ratio, 0.67; 95% confidence interval, 0.50-0.90, p = 0.008).

Conclusion: This study demonstrated that a 12-week mobile application-based lifestyle intervention is associated with improved glycemic control and body composition, particularly among manufacturing company employees with elevated baseline HbA1c and BMI. Early reductions in glycemic variability indicated the intervention's potential for rapid and sustained metabolic benefits.