Fit4D Personalized Diabetes Coaching

by dana lewis

Whether it's the holidays or the rapidly approaching “swimsuit season,” there is usually pressure throughout the year to stay active. However, as a person with diabetes, you may feel as I do that there is an additional pressure to be fit and active, to disprove the stereotypes of living with diabetes. In this spirit, when diaTribe asked, I decided to try out Fit4D personalized diabetes coaching to see what impact it would have on my diabetes management and overall quality of life.

Editor’s note: Fit4D is offering a 10% discount for all diaTribe readers! The discount applies to all Fit4D coaching calls and memberships. To apply your discount, head to www.Fit4D.com and enter the coupon code “diatribe” upon checkout.

Fit4D provides personalized fitness and nutrition coaching to people with diabetes via virtual coaching teams that include nurses, nutrition specialists, and fitness coaches. Fit4D coaches help people with diabetes who have goals such as managing weight and learning to exercise. Additionally, the Fit4D team works with your doctor or healthcare provider to establish and reach health and diabetes goals. There is a two-month fee of $175.

getting started

Getting started with Fit4D takes a bit of time. You begin by filling out a series of forms that provide information to your coaching team about your eating habits, favorite foods, exercise schedule, work/life schedule, etc. It took me a couple of hours to analyze all of my habits, provide the information, and establish my personal goals. You also sign waivers that allow them to access your medical records and communicate with your healthcare team.

Fit4D coaching team

Following sign-up, you are assigned a three-person “coaching team” that helps you with diet, exercise, and overall health and wellness. Based on the initial forms and follow-up conversations, together they help you establish and refine your goals in different areas. Goals can either be numerical (e.g., decrease A1c by x points, lose x pounds) or behavioral (e.g., increase testing, reduce food intake, improve physical activity patterns) – I chose the latter route, to help improve my daily routines. Luckily, I’m happy with my A1c, but I do think I might find a team even more helpful if I were looking for improvement there.

To start, I spoke with my fitness coach about establishing a regular exercise program. I should probably note upfront that I am a slightly difficult person to schedule exercise for because my class and meeting schedule changes on a daily and weekly basis; I can usually only make time for exercise late at night. Additionally, the gym is miles away, and it's a hassle for me to haul myself and diabetes supplies there late at night. Thus, after discussing my concerns, the team and I decided to see if we could instead build a training program for me that I could do from my home and on the running trails nearby.

My coach was great about listening to my past obstacles that prevented me from a normal training schedule and really developed a training program to fit my needs. Based on my previous experiences with scheduled/regular exercise, her recommendations were spot-on, focusing on strength exercises that I could do that would fit my schedule (push-ups, sit-ups, lunges, squats) and regular training to increase my running endurance. She also did a great job encouraging me to find a specific goal, such as participating in a 5k race, and varying the program to counter the boredom I told her I often encountered when repeating the same exercise routine.

My fitness coach also showed me the Fit4D workout web site program where she would upload my workouts. I was supposed to go online, check the workouts, complete them, and then “log” them with comments.

Since I was previously having a hard time fitting exercise into my schedule, I’ll admit it was difficult to stay engaged in the program. The process also felt a little cumbersome – logging the workouts wasn't completely self-explanatory and the navigation on the web site felt a bit clumsy. At the beginning, I could never seem to figure out when a new workout was uploaded by my coach until I inadvertently stumbled across the email alerts that would email me about my workout plans every few days.

Additionally, I worked with my nutrition coach. Since I have celiac disease, which eliminates a lot of my diabetes-friendly/go-to foods, my nutritional goals really focused on finding healthy yet convenient foods for when I’m “on the go.” I was also worried about the increase in carbohydrates that I had recently noticed in my diet as a result of my busy lifestyle. I was very happy that my Fit4D nutrition coach worked to help me develop an alternate list of snacks that were 15 grams of carbs each and gluten-free.

I also had a nurse/CDE/general health coach as part of the Fit4D program, but I didn't work with her as much as I did the rest of the team. Because my numbers were within my target range, I didn't receive much feedback from my coach after completing the blood glucose log. After the conclusion of the program, though, I did have the opportunity to follow up with her and see what tips and resources she usually provides to participants who are seeking more active coaching in this area. She typically uses the nutrition tracker information to “play detective” to determine possible tweaks for medication or lifestyle changes that could help increase control and quality of life. The coach specifically mentioned reviewing insulin to carb ratios, the amount and type of carbs (too few/too many), activity factors, and whether basal rates are skewing blood sugar results.

looking back

Overall, Fit4D seems like an excellent service for people who need individualized diabetes and general health coaching but can't get it from their doctor or educator or in the area they live. My coaching team was very attuned to my needs and readily available to fine-tune my training program. However, I personally felt challenged to find enough time to work with my coaches regularly to try to get maximum return from the program, while maintaining my already substantive time commitment to daily diabetes care, which includes testing almost a dozen times per day and using my insulin pump effectively (as well as trying to keep diabetes from overwhelming my life). You may need a specific mindset to make it a success – more than the familiar "I invested money in it, so I should stick with it."

I also tested out a month's membership of "StayFit," which is a follow-up program from Fit4D to make sure participants have adequate support after the active coaching program ends. The goal of StayFit is to help individuals maintain the progress made during Fit4D membership and to stay on track or develop new goals. Whereas Fit4D used phone and e-mail to connect, StayFit is an email-centric communication program. In my case, it worked really well! I used StayFit when it snowed for several days in Alabama, and my fitness coach helped me identify additional exercises to try indoors. While you can access the Fit4D workout log website during this time, I found it just as easy to email a few days' workouts to my coach to get immediate feedback and recommendations. When I asked about new exercises to try indoors to target certain muscle groups, my coach even sent links to YouTube clips to show me how to do the exercises.

Fit4D recommends 6-8 months of StayFit membership following your regular Fit4D program coaching, and it can be cancelled at any time. One of the great features is that you can choose a member of your team to be your StayFit coach. So, if you worked with your nutrition coach the most during Fit4D membership and are still working on those goals, that coach can continue to help you as needed during StayFit. StayFit is $35 per month. Fit4D also has a service on their site where you can schedule an appointment to talk to a coaching expert for 15 minutes for $25, and $1.50 for each minute after. If you've grown used to the support from Fit4D and like having direct access to diabetes coaches, StayFit is definitely a good deal for the following months!

recommendations

Overall, I could really see this program working for many patients, especially those who are trying to improve their glucose control. My only complaint is that it was confusing to communicate with my team at times through email. Sometimes, different coaches would be copied on different emails, and many emails often had the same general subject lines such as “Hello from Fit4D.” Additionally, the user interface could be improved so it is easier to navigate and log workouts. However, these things would be relatively easy for Fit4D to address. As the saying goes, “your mileage (and diabetes) may vary,” and there is a strong opportunity for Fit4D to reach out and work with the many people with diabetes who have been alienated by the current healthcare system or for other reasons are seeking additional support for daily diabetes care.