Abstract
Background: Type 2 Diabetes (T2D) remains one of the great global public health challenges, with around a third of the million people diagnosed in Portugal still having inadequate glycemic control. The aim of the present study was to evaluate the impact of the support of healthcare professionals (HCP) on diabetes self-management mediated by a digital solution, the eDiabetes© educational platform, namely on behaviour change goals established by participants with diabetes.
Approach: This is a prospective longitudinal study with intervention in adults with T2D, recruited in both primary care and specialized diabetes care setting. The eDiabetes platform derives from co-creation processes, involving HCP and people with T2D. It provides weekly materials on diabetes and relating topics, and on digital literacy. Monitoring is personalized and directed to the specific objectives of each participant, and is carried out by the healthcare professionals who support goal establishing and regularly follow the users, with biometric, clinical assessments, and application of questionnaires throughout the intervention. For example, we evaluated diabetes distress through the PAID questionnaire, and digital literacy with the eHEALS questionnaire.
Results: A total of 87 persons with type 2 diabetes have accepted enrolment in the platform thus far, 65% male, mean age of 61.0±7.4 years of age. The studied population presented a mean digital literacy, and relatively low mean diabetes distress. SMART objectives were established in accordance with each person with diabetes, after a motivational interview, evaluation of clinical and biometric parameters, physical activity, and sleep quality. Most users established goals related with physical activity (82%), namely regarding increase intensity, exercises adapted for sitting position, walks, and exercises for muscle tone. Other goals mentioned were related with nutrition, regarding reducing food quantity, controlling compulsion and potentiating satiety, and clarification of meal composition.
Implications: The eDiabetes platform has the potential to operationalize the promotion of healthy lifestyles, supporting a holistic view of the integrated pathway of daily life, self-care, and treatment for people with diabetes, in direct articulation with the healthcare team. Attention to promoting digital literacy contributes to mitigate barriers to the use of digital technologies and to facilitate access to reliable information, and support better navigation of the healthcare system.