Interventions with a duration of 2 - 6 months providing professional-led support with asynchronous and synchronous communication appeared to be associated with significant well-being outcomes .
While the meta-analyses demonstrated nonsignificant results for depression and distress scores , this review has shown that there is a potential for Web-based interventions to improve well-being outcomes in type 2 diabetes .
BACKGROUND Poor diabetes self-care can have a negative impact on psychological well-being and quality of life .
Given the scarcity of traditional psychological support and the barriers to uptake of and attendance at face-to-face education programs , Web-based interventions are becoming a popular approach to provide an additional platform for psychological support in long-term conditions .
However , there is limited evidence to assess the effect of Web-based psychological support in people with type 2 diabetes .
OBJECTIVE This systematic review is the first review to critically appraise and quantify the evidence on the effect of Web-based interventions that aim to improve well-being in people with type 2 diabetes .
Changes in Diabetes Distress Related to Participation in an Internet-Based Diabetes Care Management Program and Glycemic Control
Background : This article investigated how changes in diabetes distress relate to receiving care management through an Internet-based care management ( IBCM ) program for diabetes and level of participation in this program . Further , it examined the relationship between diabetes distress and changes in glycemic control . Methods : We enrolled patients of the Veterans Affairs Boston Healthcare System with diabetes who had hemoglobin A1c ( HbA1c ) levels of ≥9.0 % . Subjects were r and omized to usual care ( n = 52 ) or IBCM ( n = 52 ) for 1 year . We measured diabetes distress at baseline and quarterly thereafter using the  Problem Areas in Diabetes ( PAID ) question naire . Glycemic control was determined by baseline and quarterly HbA1c . For subjects r and omized to IBCM , we measured participation by observing frequency and consistency of their usage of the IBCM patient portal over 12 months . Linear mixed models were used to analyze THE data . Results : PAID scores declined over time for both treatment groups . Among subjects r and omized to IBCM , the decline in PAID scores over time was significant for sustained users of the IBCM patient portal but not for nonusers . Moreover , subjects whose usage of the patient portal was sustained throughout the study had lower PAID scores at baseline . With respect to changes in glycemic control , HbA1c reduced individual differences in PAID scores by 44 % ; a lower baseline HbA1c was associated with lower baseline PAID scores , and over time , the decrease in HbA1c was associated with further decreases in the PAID score . Conclusions : Participation in IBCM varies by initial diabetes distress , with people with less distress participating more . For people who participate , IBCM further mitigates diabetes distress . There is also a relationship between achievements in glycemic control and subsequent lowering of diabetes distress . Future research should identify how to maximize fit between patient needs and the provisions of IBCM , with the aim of increasing patient engagement in the active management of their health using this care modality . A key to maximizing fit might be first addressing metabolic control aggressively and then using IBCM for sustainment of health
Interventions with a duration of 2 - 6 months providing professional-led support with asynchronous and synchronous communication appeared to be associated with significant well-being outcomes .
While the meta-analyses demonstrated nonsignificant results for depression and distress scores , this review has shown that there is a potential for Web-based interventions to improve well-being outcomes in type 2 diabetes .
BACKGROUND Poor diabetes self-care can have a negative impact on psychological well-being and quality of life .
Given the scarcity of traditional psychological support and the barriers to uptake of and attendance at face-to-face education programs , Web-based interventions are becoming a popular approach to provide an additional platform for psychological support in long-term conditions .
However , there is limited evidence to assess the effect of Web-based psychological support in people with type 2 diabetes .
OBJECTIVE This systematic review is the first review to critically appraise and quantify the evidence on the effect of Web-based interventions that aim to improve well-being in people with type 2 diabetes .