We report on the 50 weeks follow up results from a healthy lifestyle pilot (High Intensity Nutrition, Training & coaching), conducted with 11 insulin - dependent Type 2 Diabetes Mellites (DM2) patients. Hybrid eH ealth support was given, with electronic support plus a multi - disciplinary health support team. Regarding the pilot goal of long term healthy lifestyle adoption in senior DM2 patients, challenges were: low ICT - and health literacy. This exploratory design analysis formulates design lessons based on 50 weeks follow up. The first 12 weeks contained intensive face - to - face and eSupported coaching. After that, patient self - management and eTools were key. After 50 weeks, attractiveness and feasibility of the in tervention were perceived as high: recommendation 9,5 out of 10 and satisfaction 9,6 out of 10. TAM (Technology Acceptance Model) surveys showed high usefulness and feasibility. Acceptance and health behaviours were reinforced by the prolonged health resu lts: Aerobic and strength capacity levels were improved at 50 weeks, plus Health Related Quality of Life (and biometric benefits and medication reductions, reported elsewhere). We draw three types of conclusions. First, patients’ health literacy and qualit y of life improved strongly, which both supported healthy behaviours, even after 50 weeks. Second, regarding eHealth theory, iterative growth cycles are beneficial for long term adoption and e - relationships. Third, a design analysis was conducted regarding long term service mix efficacy in relation to key requirements for designing ICT - enabled lifestyle interventions. Several suggestions for long term lifestyle eSupport are given.

Advanced diabetes-type-2 patients often have high insulin resistance. Over the years their insulin medication rises, which further increases their insulin resistance and glucose management problems. A HINTc (High Intensity Nutrition, Training & coaching) pilot study was conducted with 11 insulin-dependent patients. Hybrid eHealth support was given, with electronic support plus a multi-disciplinary health support team. Based on preliminary 12 week results, attractiveness and feasibility of the intervention were high: recommendation 9,0 out of 10 and satisfaction 9,1 out of 10. TAM (Technology Acceptance Model) surveys showed high usefulness, feasibility and intentions for future use. Acceptance and health behaviours were also reinforced by the rapid results (average 9% weight loss, 20% lower fasting glucose and 71% lower insulin medication, plus a 46% increase on the Quality of Life Physical Health dimension). Our analysis supports three types of conclusions. First, patients’ health literacy and quality of life improved strongly, both supporting healthier behaviours. Second, a virtuous cycle was started, helping patients reverse diabetes-2 progression. Third, a design analysis was conducted regarding service mix efficacy in relation to key requirements for designing ICT-enabled lifestyle interventions.