NEW YORK (Reuters Health) - Giving people with type 2 diabetes the opportunity to help manage their care online can substantially improve their long-term blood sugar control, new research suggests.

Clinic visits alone aren't enough for many people with diabetes, Dr. James D. Ralston of the Group Health Cooperative in Seattle and colleagues note in the journal Diabetes Care.

The researchers tested whether an Internet-based program might help patients to manage their care more effectively.

The intervention gave patients access to the same medical records used by their primary care doctor, as well as the ability to e-mail health care providers. The program also provided feedback on blood sugar readings, a website with educational information on diabetes, and an interactive diary that allowed users to record information on diet, exercise and medications.

Ralston and colleagues randomized 83 type 2 diabetics to usual care plus the Internet intervention or usual care only. All study subjects had levels of the blood sugar marker glycohemoglobin (GHb) of 7 percent or above, indicating poor long-term blood sugar control.

After a year, patients participating in the Web program saw an average 0.7 percent drop in their GHb levels compared to those who weren't participating, while 33 percent of Web program users had GHb levels below 7 percent. In contrast, just 11 percent of non-users had brought their GHb levels below 7 percent.

Compared with other trials of care management outside the office-based setting, the Web technology behind our intervention was relatively low cost and already in use by many patients in other aspects of their daily lives, Ralston's team notes.

Nevertheless, they add, many people with diabetes lack such resources. Although interventions similar to this study may uniquely address some existing disparities in access to care, they add, they may also fail to address or may even exacerbate other disparities.

SOURCE: Diabetes Care, February 2009.

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