Early Insights From a Digitally Enhanced Diabetes Self-Management Education and Support Program: Single-Arm Nonrandomized Trial

Wilson-Anumudu, Folasade; Quan, Ryan; Castro Sweet, Cynthia; Cerrada, Christian; Juusola, Jessie; Turken, Michael; Bradner Jasik, Carolyn

BACKGROUND: Translation of diabetes self-management education and support (DSMES) into a digital format can improve access, but few digital programs have demonstrated outcomes using rigorous evaluation metrics. OBJECTIVE: The aim of this study was to evaluate the impact of a digital DSMES program on hemoglobin A(1c) (HbA(1c)) for people with type 2 diabetes. METHODS: A single-arm, nonrandomized trial was performed to evaluate a digital DSMES program that includes remote monitoring and lifestyle change, in addition to comprehensive diabetes education staffed by a diabetes specialist. A sample of 195 participants were recruited using an online research platform (Achievement Studies, Evidation Health Inc). The primary outcome was change in laboratory-tested HbA(1c) from baseline to 4 months, and secondary outcomes included change in lipids, diabetes distress, and medication adherence. RESULTS: At baseline, participants had a mean HbA(1c) of 8.9% (SD 1.9) and mean BMI of 37.5 kg/m(2) (SD 8.3). The average age was 45.1 years (SD 8.9), 70% were women, and 67% were White. At 4-month follow up, the HbA(1c) decreased by 0.8% (P<.001, 95% CI –1.1 to –0.5) for the total population and decreased by 1.4% (P<.001, 95% CI –1.8 to –0.9) for those with an HbA(1c) of >9.0% at baseline. Diabetes distress and medication adherence were also significantly improved between baseline and follow up. CONCLUSIONS: This study provides early evidence that a digitally enhanced DSMES program improves HbA(1c) and disease self-management outcomes.