New research from Texas A&M reveals that virtual diabetes self-management programs significantly reduce hemoglobin A1c levels, offering hope for those managing Type 2 diabetes in rural and urban areas.
A new study by Texas A&M University School of Public Health has shown that accessible and cost-effective virtual self-management programs can significantly lower the blood sugar levels of individuals with Type 2 diabetes.
The research, published in Frontiers in Public Health, aimed to assess how different virtual diabetes self-management interventions impact hemoglobin A1c levels, a crucial marker for diagnosing and managing diabetes.
“There are many self-management interventions for people living with Type 2 diabetes, but until now little research has been conducted on their effectiveness based on how they are delivered or when they are used in combination,” lead researcher Marcia Ory, the Regents and Distinguished Professor with the Texas A&M School of Public Health and the Center for Community Health and Aging, said in a news release.
The study monitored 189 adults with unmanaged Type 2 diabetes (A1c levels of 7.5 or higher) across 46 counties in Texas, both urban and rural. The participants had a median age of 52, with men constituting 23% of the group and 35% residing in rural areas. The majority were white (86%) and non-Hispanic/Latino (61%), and over half reported having poor or fair health.
The trial, which involved three interventions with participants randomly assigned to two treatments along with a control group, ran from November 2020 to March 2022.
The first intervention was a structured virtual education and support program with one-on-one counseling. It involved 6-8 hours of asynchronous virtual training followed by personalized interactions with a nurse or dietitian to tailor specific diabetes management strategies.
The second intervention provided participants with a smartphone app for diabetes self-care, featuring chat access to a coach for support.
The third intervention followed a sequential combination of the two approaches with added app access to the virtual education and support program.
Each intervention lasted three months. Participants’ A1c levels were measured at baseline and at three- and six-month intervals.
An intent-to-treat analysis revealed that all three methods effectively reduced A1c levels, with older participants and those in better baseline health seeing the most significant improvements.
“These findings support other studies that found similar diabetes self-management interventions to be effective,” added Ory. “In contrast to other studies, however, our longitudinal analyses found that A1c levels remained lower over time, suggesting that providing self-paced training and skill development could have a lasting impact, despite the particular virtual delivery mode.”
Participation and retention rates were remarkably high, with about 90% of participants completing the six-month study duration. Matthew Lee Smith attributed this success to the adaptability and interactive nature of the programs.
However, co-author Gang Han cautioned against generalizing the results to all diabetes patients due to the study’s sample limitations. Most participants were English speakers with digital access and lived within Texas. Additionally, the COVID-19 pandemic posed challenges to recruiting participants and required protocol updates.
“Still, we expect that many people with unmanaged Type 2 diabetes — including those from underrepresented groups or who have less access to health care — could experience similar benefits,” Ory added.
This is cause for hope, according to Ory, given the alarming rise in Type 2 diabetes cases, which have doubled in the United States over the past 20 years, leading to increased risks of heart disease, stroke, kidney failure and other severe health conditions.
Source: Texas A&M University