Randomised-controlled trial of a web-based dietary intervention for patients with type 2 diabetes: Changes in health cognitions and glycemic control

Journal article


Amutha Ramadas, Carina Chan, Brian Oldenburg, Zanariah Hussain and Kia Fatt Quek. (2018) Randomised-controlled trial of a web-based dietary intervention for patients with type 2 diabetes: Changes in health cognitions and glycemic control. BMC Public Health. 18(1), pp. 1-13. https://doi.org/10.1186/s12889-018-5640-1
AuthorsAmutha Ramadas, Carina Chan, Brian Oldenburg, Zanariah Hussain and Kia Fatt Quek
Abstract

Background
Increasing prevalence and disease burden has led to an increasing demand of programs and studies focused on dietary and lifestyle habits, and chronic diseases such as type 2 diabetes mellitus (T2DM). We evaluated the effects of a 6-month web-based dietary intervention on Dietary Knowledge, Attitude and Behaviour (DKAB), Dietary Stages of Change (DSOC), fasting blood glucose (FBG) and glycosylated haemoglobin (HbA1c) in patients with uncontrolled HbA1c (> 7.0%) in a randomised-controlled trial (myDIDeA) in Malaysia.

Methods
The e-intervention group (n = 62) received a 6-month web-delivered intensive dietary intervention while the control group (n = 66) continued with their standard hospital care. Outcomes (DKAB and DSOC scores, FBG and HbA1c) were compared at baseline, post-intervention and follow-up.

Results
While both study groups showed improvement in total DKAB score, the margin of improvement in mean DKAB score in e-intervention group was larger than the control group at post-intervention (11.1 ± 0.9 vs. 6.5 ± 9.4,p < 0.001) and follow-up (19.8 ± 1.1 vs. 7.6 ± 0.7,p < 0.001), as compared to the baseline. Although there was no significant difference between intervention and control arms with respect to DSOC score and glycaemic control, the e-intervention group showed improved DSOC score (199.7 ± 18.2 vs193.3 ± 14.6,p = 0.046), FBG (7.9 ± 2.5 mmol/L vs. 8.9 ± 3.9 mmol/L,p = 0.015) and HbA1c (8.5 ± 1.8% vs. 9.1 ± 2.0%,p = 0.004) at follow-up compared to the baseline, whereas such improvement was not seen in the control group.

Conclusions
Most important impact of myDIDeA was on the overall DKAB score. This study is one of the first to demonstrate that an e-intervention can be a feasible method for implementing chronic disease management in developing countries. Concerns such as self-monitoring, length of intervention, intense and individualized intervention, adoption of other domains of Transtheoretical Model and health components, and barriers to change have to be taken into consideration in the development of future intervention programs.

Keywordsdiabetes mellitus, type 2; telemedicine ; diet therapy ; randomised-controlled trial
Year2018
JournalBMC Public Health
Journal citation18 (1), pp. 1-13
PublisherBioMed Central
ISSN1471-2458
Digital Object Identifier (DOI)https://doi.org/10.1186/s12889-018-5640-1
Scopus EID2-s2.0-85048270673
Open accessPublished as ‘gold’ (paid) open access
Publisher's version
License
File Access Level
Open
Publication process dates
Deposited12 May 2021
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