Online Diabetes Self-Management Program
Open accessAbstract
OBJECTIVE: We hypothesized that people with type 2 diabetes in an online diabetes self-management program, compared with usual-care control subjects, would 1) demonstrate reduced A1C at 6 and 18 months, 2) have fewer symptoms, 3) demonstrate increased exercise, and 4) have improved self-efficacy and patient activation. In addition, participants randomized to listserve reinforcement would have better 18-month outcomes than participants receiving no reinforcement. RESEARCH DESIGN AND METHODS: A total of 761 participants were randomized to 1) the program, 2) the program with e-mail reinforcement, or 3) were usual-care control subjects (no treatment). This sample included 110 American Indians/Alaska Natives (AI/ANs). Analyses of covariance models were used at the 6- and 18-month follow-up to compare groups. RESULTS: At 6 months, A1C, patient activation, and self-efficacy were improved for program participants compared with usual care control subjects (P < 0.05). There were no changes in other health or behavioral indicators. The AI/AN program participants demonstrated improvements in health distress and activity limitation compared with usual-care control subjects. The subgroup with initial A1C >7% demonstrated stronger improvement in A1C (P = 0.01). At 18 months, self-efficacy and patient activation were improved for program participants. A1C was not measured. Reinforcement showed no improvement. CONCLUSIONS: An online diabetes self-management program is acceptable for people with type 2 diabetes. Although the results were mixed they suggest 1) that the program may have beneficial effects in reducing A1C, 2) AI/AN populations can be engaged in and benefit from online interventions, and 3) our follow-up reinforcement appeared to have no value.
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The most successful internet interventions include varied components and interactive elements to encourage engagement.
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Self-citation
- Authors
- Lorig, K., Ritter, P. L., Laurent, D. D., Plant, K., Green, M., Jernigan, V. B. B., & Case, S.
- Affiliations
- Stanford Medicine (US)
- Stanford University (US)
- Yale University (US)
- Corresponding author
- Ritter, Philip L.
- ORCID
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2010-03-18
- Volume
- 33
- Issue
- 6
- Pages
- 1275-1281
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC2875437
- OpenAlex
- W2133814384
- Semantic Scholar
- 989944dfe14ee0dcf6d61f0160a280c4de49ce71
- Cited by
- 316
- References
- 23
- Citations by year
- 2026: 6 · 2025: 11 · 2024: 10 · 2023: 6 · 2022: 16 · 2021: 16 · 2020: 21 · 2019: 19 · 2018: 25 · 2017: 26 · 2016: 34 · 2015: 41 · 2014: 30 · 2013: 26 · 2012: 18
- FWCI
- 13.03
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes Care (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r18dk065729-04)
- National Heart, Lung, and Blood Institute (T32HL007034)
- National Institute of Diabetes and Digestive and Kidney Diseases (1R18DK065729, R18 DK065729)
- 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 › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- type 2 diabetes, diabetes self-management, online intervention, glycemic control, HbA1c, self-efficacy, patient activation, American Indians and Alaska Natives, health distress, physical activity, program acceptability
- MeSH terms
- Adult, Diabetes Mellitus, Type 2, Female, Glycated Hemoglobin, Humans, Male, Middle Aged, Outcome Assessment, Health Care, Disease Management, Internet, Electronic Mail, Young Adult
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