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 .
Cost-Effectiveness of Automated Telephone Self-Management Support With Nurse Care Management Among Patients With Diabetes
PURPOSE This study evaluated the cost-effectiveness of an automated telephone self-management support with nurse care management ( ATSM ) intervention for patients with type 2 diabetes , which was tested among patients receiving primary care in publicly funded ( safety net ) clinics , focusing on non-English speakers . METHODS We performed cost analyses in the context of a r and omized trial among primary care patients comparing the effects of ATSM ( n = 112 ) and usual care ( n = 114 ) on diabetes-related outcomes in 4 San Francisco safety net clinics .  ATSM uses interactive phone technology to provide surveillance , patient education , and one-on-one counseling , and was implemented in 3 language s for a 9-month period . Cost utility was examined using quality -adjusted life-years ( QALYs ) derived from changes in scores on the 12-Item Short Form Health Survey . We also examined cost-effectiveness for costs associated with a 10 % increase in the proportion of patients meeting diabetes-specific public health goals for increasing exercise , as recommended by Healthy People 2010 and the American Diabetes Association . RESULTS The annual cost of the ATSM intervention per QALY gained , relative to usual care , was $ 65,167 for start-up and ongoing implementation costs combined , and $ 32,333 for ongoing implementation costs alone . In sensitivity analyses , costs per QALY ranged from $ 29,402 to $ 72,407 . The per-patient cost to achieve a 10 % increase in the proportion of intervention patients meeting American Diabetes Association exercise guidelines was estimated to be $ 558 when all costs were considered and $ 277 when only ongoing costs were considered . CONCLUSIONS The ATSM intervention for diverse patients with diabetes had a cost utility for functional outcomes similar to that of many other accepted interventions targeted at diabetes prevention and treatment , and achieved public health physical activity objectives at modest costs . Because a considerable proportion of costs were fixed , cost-utility and cost-effectiveness estimates would likely be substantially improved in a scaled-up ATSM program
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 .