There were three reported  deaths out of 3578 participants .Computer-based  diabetes self-management interventions currently have limited effectiveness .
Current interventions do not show adequate evidence for improving depression , health-related quality of life or weight .
AUTHORS ' CONCLUSIONS Computer-based diabetes self-management interventions to manage type 2 diabetes appear to have a small beneficial effect on blood glucose control and the effect was larger in the mobile phone subgroup .
There is no evidence to show benefits in other biological outcomes or any cognitive , behavioural or emotional outcomes
BACKGROUND Diabetes is one of the commonest chronic medical conditions , affecting around 347 million adults worldwide .
Structured patient education programmes reduce the risk of diabetes-related complications four-fold .
Internet-based self-management programmes have been shown to be effective for a number of long-term conditions , but it is unclear what are the essential or effective components of such programmes .
If computer-based self-management interventions improve outcomes in type 2 diabetes , they could potentially provide a cost-effective option for reducing the burdens placed on patients and healthcare systems by this long-term condition .
OBJECTIVES To assess the effects on health status and health-related quality of life of computer-based diabetes self-management interventions for adults with type 2 diabetes mellitus .
Effects of Self-Management Support on Structure, Process, and Outcomes Among Vulnerable Patients With Diabetes
OBJECTIVE Despite the importance of self-management support ( SMS ) , few studies have compared SMS interventions , involved diverse population s , or entailed implementation in safety net setting s. We examined the effects of two SMS strategies across outcomes corresponding to the Chronic Care Model . RESEARCH DESIGN AND METHODS A total of 339 out patients with poorly controlled diabetes from county-run clinics were enrolled in a three-arm trial . Participants , more than half of whom spoke limited English , were uninsured , and /or had less than a high school education , were r and omly assigned to  usual care , interactive weekly automated telephone self-management support with nurse follow-up ( ATSM ) , or monthly group medical visits with physician and health educator facilitation ( GMV ) . We measured 1-year changes in structure ( Patient Assessment of Chronic Illness Care [ PACIC ] ) , communication processes ( Interpersonal Processes of Care [ IPC ] ) , and outcomes ( behavioral , functional , and metabolic ) . RESULTS Compared with the usual care group , the ATSM and GMV groups showed improvements in PACIC , with effect sizes of 0.48 and 0.50 , respectively ( P < 0.01 ) . Only the ATSM group showed improvements in IPC ( effect sizes 0.40 vs. usual care and 0.25 vs. GMV , P < 0.05 ) . Both SMS arms showed improvements in self-management behavior versus the usual care arm ( P < 0.05 ) , with gains being greater for the ATSM group than for the GMV group ( effect size 0.27 , P = 0.02 ) . The ATSM group had fewer bed days per month than the usual care group ( −1.7 days , P = 0.05 ) and the GMV group ( −2.3 days , P < 0.01 ) and less interference with daily activities than the usual care group ( odds ratio 0.37 , P = 0.02 ) . We observed no differences in A1C change . CONCLUSIONS Patient-centered SMS improves certain aspects of diabetes care and positively influences self-management behavior . ATSM seems to be a more effective communication vehicle than GMV in improving behavior and quality of life
There were three reported  deaths out of 3578 participants .Computer-based  diabetes self-management interventions currently have limited effectiveness .
Current interventions do not show adequate evidence for improving depression , health-related quality of life or weight .
AUTHORS ' CONCLUSIONS Computer-based diabetes self-management interventions to manage type 2 diabetes appear to have a small beneficial effect on blood glucose control and the effect was larger in the mobile phone subgroup .
There is no evidence to show benefits in other biological outcomes or any cognitive , behavioural or emotional outcomes
BACKGROUND Diabetes is one of the commonest chronic medical conditions , affecting around 347 million adults worldwide .
Structured patient education programmes reduce the risk of diabetes-related complications four-fold .
Internet-based self-management programmes have been shown to be effective for a number of long-term conditions , but it is unclear what are the essential or effective components of such programmes .
If computer-based self-management interventions improve outcomes in type 2 diabetes , they could potentially provide a cost-effective option for reducing the burdens placed on patients and healthcare systems by this long-term condition .
OBJECTIVES To assess the effects on health status and health-related quality of life of computer-based diabetes self-management interventions for adults with type 2 diabetes mellitus .