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Cited by 69Diabetes Management and EducationMobile Health and mHealth ApplicationsNutrition, Health and Food Behavior

Randomised-controlled trial of a web-based dietary intervention for patients with type 2 diabetes: changes in health cognitions and glycemic control

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Ramadas, Amutha, Chan, Carina Ka Yee, Oldenburg, Brian, Hussein, Zanariah, Quek, Kia Fatt·2018·BMC Public Health
DOI 10.1186/s12889-018-5640-1PMC PMC5994015
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Abstract

BACKGROUND: Increasing prevalence and disease burden has led to an increasing demand of programs and studies focused on dietary and lifestyle habits, and chronic diseases such as type 2 diabetes mellitus (T2DM). We evaluated the effects of a 6-month web-based dietary intervention on Dietary Knowledge, Attitude and Behaviour (DKAB), Dietary Stages of Change (DSOC), fasting blood glucose (FBG) and glycosylated haemoglobin (HbA1c) in patients with uncontrolled HbA1c (> 7.0%) in a randomised-controlled trial (myDIDeA) in Malaysia. METHODS: The e-intervention group (n = 62) received a 6-month web-delivered intensive dietary intervention while the control group (n = 66) continued with their standard hospital care. Outcomes (DKAB and DSOC scores, FBG and HbA1c) were compared at baseline, post-intervention and follow-up. RESULTS: While both study groups showed improvement in total DKAB score, the margin of improvement in mean DKAB score in e-intervention group was larger than the control group at post-intervention (11.1 ± 0.9 vs. 6.5 ± 9.4,p < 0.001) and follow-up (19.8 ± 1.1 vs. 7.6 ± 0.7,p < 0.001), as compared to the baseline. Although there was no significant difference between intervention and control arms with respect to DSOC score and glycaemic control, the e-intervention group showed improved DSOC score (199.7 ± 18.2 vs193.3 ± 14.6,p = 0.046), FBG (7.9 ± 2.5 mmol/L vs. 8.9 ± 3.9 mmol/L,p = 0.015) and HbA1c (8.5 ± 1.8% vs. 9.1 ± 2.0%,p = 0.004) at follow-up compared to the baseline, whereas such improvement was not seen in the control group. CONCLUSIONS: Most important impact of myDIDeA was on the overall DKAB score. This study is one of the first to demonstrate that an e-intervention can be a feasible method for implementing chronic disease management in developing countries. Concerns such as self-monitoring, length of intervention, intense and individualized intervention, adoption of other domains of Transtheoretical Model and health components, and barriers to change have to be taken into consideration in the development of future intervention programs. TRIAL REGISTRATION: ClinicalTrials.gov NCT01246687 .

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Cited by

Sorted by citations

Authors
Ramadas, A., Chan, C. K. Y., Oldenburg, B., Hussein, Z., & Quek, K. F.
Affiliations
  • Monash University Malaysia (MY)
  • Australian Catholic University (AU)
  • The University of Melbourne (AU)
  • Ministry of Health (MY)
Corresponding author
Ramadas, Amutha
ORCID
Venue
BMC Public Health
Publisher
Springer Science and Business Media LLC
Published
2018-06-08
Volume
18
Issue
1
Pages
716-716
ISSN
1471-2458 (ISSN-L)
DOI
10.1186/s12889-018-5640-1
PMC
PMC5994015
OpenAlex
W2806977188
Cited by
69
References
6
Citations by year
2026: 5 · 2025: 11 · 2024: 8 · 2023: 7 · 2022: 15 · 2021: 14 · 2020: 6 · 2019: 3
FWCI
4.58
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Public Health (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by)
  • Monash University Research Portal (Monash University) (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Minerva Access (University of Melbourne) (submittedVersion, cc-by)
Funders
  • Monash University Malaysia (MED2009-CM (SG)-004-QKF)
  • Fogarty International Center (D43TW008332)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
  • Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
Keywords
type 2 diabetes, glycemic control, HbA1c, fasting blood glucose, health cognitions, chronic disease management, developing countries, self-monitoring, diabetes self-management education, Malaysia, hospital-based intervention, feasibility and acceptability
MeSH terms
Adult, Diabetes Mellitus, Type 2, Diet, Feasibility Studies, Female, Health Promotion, Glycated Hemoglobin, Humans, Health Knowledge, Attitudes, Practice, Malaysia, Male, Middle Aged, Patient Education as Topic, Program Evaluation, Internet

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