Web-based program benefits type 2 diabetes glycemic control
medwireNews: A web-based self-management program significantly improves glycemic control in people with type 2 diabetes compared with simple website information, UK trial findings suggest.
And while the web-based program did not impact diabetes-related distress overall, there were indications it reduced distress among participants with more recently diagnosed diabetes.
Participants using the Healthy Living for People with Diabetes (HeLP-Diabetes) online program had mean glycated hemoglobin (HbA1c) levels that were 0.24% lower at 12 months compared with those given access to a text-based website containing basic information.
The researchers note: “Each 1% reduction in HbA1c is associated with a risk reduction of 21% for deaths related to diabetes and a 37% risk reduction for microvascular complications.
“A reduction in HbA1c of 0.24% across a population level could translate into considerable population benefit, particularly as this web-based intervention could be delivered at low-cost and at scale across the UK.”
The individually randomized, two-arm controlled trial was conducted at 21 English primary care practices in 374 adults aged 18 years or over with type 2 diabetes. Participants were randomly assigned to HeLP-Diabetes (n=185) or control website information (n=189), with both groups receiving an initial facilitation session by a practice nurse.
The joint primary outcomes of HbA1c levels and diabetes-related distress at 12 months were measured using the Problem Areas in Diabetes (PAID) scale. Data obtained within the predefined window of 10 to 14 months were available for 291 (78%) participants regarding HbA1c levels, and for 321 (86%) regarding diabetes-related distress.
HbA1c levels decreased by 0.08% after 12 months from a baseline value of 7.26% in the HeLP-Diabetes group, whereas they increased by 0.16% from a baseline of 7.35% in the control group, a statistically significant difference.
There was no significant difference in the mean PAID score, with a reduction in both groups during the trial, but a prespecified subgroup analysis of participants with more recently diagnosed diabetes showed a beneficial impact from intervention.
Reporting in BMJ Open, Elizabeth Murray (University College London) and co-researchers write: “On the basis of these results, HeLP-Diabetes may be considered as an addition to the current menu of self-management support for people with type 2 diabetes, and may help increase overall access and uptake.”
By Anita Chakraverty
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