JMIR Publications

ABSTRACT

Background:

Diabetes Mellitus (DM) is a serious chronic disorder that affects many individuals globally, particularly persons with disability, and has long-term adverse effects on the health of individuals and society. Effective self-management education is therefore required. Diabetes management focused on Medical Nutrition Therapy and Diabetes Self-Management Education combined with telehealth technology has the potential to increase the active performance of diabetes management behaviors among this population and improve their overall quality of life and quality of self-care.

Objective:

This study aims to evaluate the impact of different levels of technology on the delivery of Medical Nutrition Therapy (MNT) and Diabetes Self-Management Education (DSME) among persons with disability.

Methods:

The study is a three-arm randomized controlled trial among adults living with both type 2 diabetes and permanent physical disability. The target sample size is 90 participants randomized into three arms: the high-tech arm which receives diabetes-related materials weekly through mediums like email, telehealth platform, and text; the low-tech arm which receives only weekly email with diabetes-related material; and an attention control arm which has no technology support. Outcomes are measured at baseline and at 6 months. Questionnaires and HbA1c measures will be used. Using multivariate linear mixed models, the study examines the relationships among the level of technology intervention and DM self-management behaviors, self-efficacy, and reductions in HbA1C. The primary outcome is the proportion of participants in each group with improved self-management behaviors, as measured by several validated questionnaires. The secondary outcome is a better HbA1c reduction. The study also incorporates qualitative assessments.

Results:

Data collection began in June 2024. The intervention is delivered to three cohorts from June 2024 to October 2024. Make-up classes are delivered to participants in any of the three cohorts between November 2024 and December 2024. The final 3-month follow-up classes are held for each cohort 3 months after the first class and are anticipated to be completed in February 2025.

Conclusions:

Effective Self-management in DM is important to reduce complications. Utilizing technology to deliver MNT and DSME could serve as an effective and convenient strategy for providing these interventions. However, intervention studies are required to determine the most effective level of technology for delivering MNT and DSME intervention to this target group. The YumABLE study is expected to provide new, meaningful, and detailed information about the effectiveness of technology and telehealth platforms for effectively delivering an MNT and DSME program. Clinical Trial: ClinicalTrials.gov NCT06049225