Cited by 316Diabetes Management and EducationMobile Health and mHealth ApplicationsDiabetes Management and Research

Online Diabetes Self-Management Program

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Lorig, Kate, Ritter, Philip L., Laurent, Diana D., Plant, Kathryn, Green, Maurice, Jernigan, Valarie Blue Bird, Case, Siobhan·2010·Diabetes Care

Abstract

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.

    “The most successful of these interventions have a variety of components and interactive elements to encourage engagement (including Beating the Blues, which is approved for use by the British National Institute for Health and Clinical Excellence [35,36,37,38,39,40].)”

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Research works printed but not linked: 3

  1. Lorig, 2006, Living a Healthy Life With Chronic Conditions
  2. Jerrigan VJ: The Native American Diabetes Self-Management Program. PHD thesis. Berkeley, California, University of California Berkeley, School of Public Health, unpublished
  3. Tyrrell, 2006, Hemoglobin A1c Detection System: A Technical Bulletin Describing the Performance Characteristics of Capillary Blood Collected on Filter Paper for Determination of Hemoglobin A1c

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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.
Venue
Diabetes Care
Published
2010-03-18
Volume
33
Issue
6
Pages
1275-1281
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
OpenAlex
W2133814384
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
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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