Effectiveness of a digital diabetes self-management education and support program in Vietnamese adults with type 2 diabetes.
Phong Vu Nhat Nguyen, Phola Thi Thach, Hoanh Kieu Tran, Ha Thi Hong Nguyen, Dai Lan Truong, Uyen Lam, Viet Quoc Tran, Nhi Y To, Nhat Tran Hoang Luong, Duong Thi Thai Le, Khanh Quang Tran, Luong Dai Ly
Abstract
Open AccessDiabetes mellitus remains a major global public health challenge. Mobile applications and digital platforms offer innovative opportunities to enhance diabetes self-management. This study aimed to evaluate the impact of diaB, a digitally delivered diabetes self-management education and support (DSMES) program, on clinical outcomes and diabetes-related knowledge in individuals with type 2 diabetes. This quasi-experimental, multicenter, open-label study involved 163 adults with type 2 diabetes, allocated to either a DSMES intervention group (n = 81) or a usual care control group (n = 82). The intervention group participated in a ten-week educational program delivered via the diaB mobile app and other digital platforms, based on the DSMES framework recommended by the American Diabetes Association. The program included online group video sessions led by doctors, nutritionists, and health coaches. Clinical outcomes-including fasting blood glucose (FBG), HbA1c, lipid profiles, weight, BMI, waist circumference, and diabetes knowledge (assessed using the Michigan Diabetes Knowledge Test, MDKT)-were measured at baseline and after the intervention. The intervention group showed significant improvements in clinical outcomes. FBG decreased from 7.5 to 6.7 mmol/L (P < 0.001), with a greater reduction than the control group (P = 0.004). HbA1c declined from 7.8 to 7.3% (P < 0.001), with no significant change in the control group. In multivariable linear regression adjusted for the disease risk score (DRS), the intervention was independently associated with greater HbA1c reduction (β = -0.72; 95% CI -1.14 to -0.31; P = 0.001), while higher DRS predicted less improvement (β = +0.57; 95% CI 0.12 to 1.01; P = 0.013). The intervention group also demonstrated greater gains in MDKT scores (+ 3 vs. -1; P < 0.001), more favorable changes in lipid profiles (P < 0.001), and greater weight loss among participants with baseline BMI ≥ 25 kg/m2 (-1.5 kg vs. 0 kg; P = 0.02). DiaB, a digitally delivered DSMES program, significantly improved glycemic control, diabetes knowledge, and metabolic outcomes. Integrating such digital interventions into routine diabetes care may enhance both clinical management and patient education in resource-limited settings.