Online tool shows positive type 2 diabetes outcomes
People with type 2 diabetes could improve their health by using a new web-based self-management tool, according to research.
Professor Elizabeth Murray, head of the research department and co-director of the eHealth unit (UCL epidemiology and public health), said: “Diabetes is an NHS priority, with around 4 million people in England living with type 2 diabetes.
“This self-management tool offers an evidence based and cost effective way to improve health outcomes, for patients both at the beginning and later on in their diagnosis, that could be offered as part of the current menu of self-management support.”
Working with clinicians at Whittington Health and researchers at University of Cambridge, the trial compared diabetes control and diabetes-related stress in a randomised group of 374 patients from 21 general practices in England whose average age was just under 65.
A total of 185 people used the HeLP-Diabetes programme developed at UCL, and a control group of 189 people used information from a static, text-based website.
Anonymised clinical data was collected for a diabetes control molecule called glycated haemoglobin (HbA1c) and diabetes-related stress data were collected via a self-report questionnaire where people scored themselves from 1 to 100 (higher scores indicating more stress) against 20 items focusing on areas that cause difficulty in everyday life.
Glycaemic control was chosen as an outcome measure as poorly controlled diabetes is associated with premature mortality and risk complications, such as cardiovascular disease. Participants made it a priority that disease-related stress was also a primary outcome measure as around 40 per cent of people with diabetes have significant level of distress, severely impacting their quality of life.
The mean baseline for HbA1c was 7.3 per cent but by the end of the trial participants in the HeLP-Diabetes group had a lower HbA1c than those in the control group (7.22 per cent and 7.46 per cent respectively). It is considered this reduction of 0.24 per cent, the difference between randomised and control group, across a population level could translate into considerable population benefit as each one per cent reduction in HbA1c is associated with a risk reduction of 21 per cent of deaths related to diabetes and a 37 per cent risk reduction in microvascular complications.
While there was no significant overall difference between groups for diabetes-related stress, it was highlighted the baseline for diabetes-related stress was exceptionally low in the trial population group. However, those who had diabetes for less than seven years showed a beneficial impact – suggesting that early intervention could be key.
Professor Murray said: “Although historically group-based sessions have been a popular choice for health care providers, online programmes offer individuals the flexibility to access support that fits around their lifestyle.
“All the content in our programme was evidence-based, drawing on a range of diabetes management research including behavioural change, accessibility and usability, and promoting emotional wellbeing by drawing on principles of cognitive behavioural therapy and mindfulness.”
Arjun Panesar, of Diabetes.co.uk, said: “This study demonstrates the power of digital technology in the management and prevention of chronic conditions. However, while the results are interesting, we are able to show a bigger reduction in HbA1c, a measurement of blood glucose over a three-month period, through our Low Carb Program.”