Table 1.

Major Studies of Diabetes Self-Management ITs

Study/DesignReach/SampleEfficacyAdoption/SettingImplementationMaintenance
Handheld Portable Devices
Rutten et al., 1990129 of 171 eligible type 2 diabetic patients aged 40–75 years from outpatient clinicsHbA1c decreased in experimental group (–0.4%) (P <0.05); no change in weightEight general practitioner and specialist clinicsIntervention received a phased therapeutic plan, consistent across sites.Individual and setting level: not reported
Marrero et al., 1995 (randomized, controlled trial)106 families with type 1 diabetic children; proportion refusing enrollment not reported (children, type 1)Significantly more calls by patients in experimental group re: management (P <0.001) and time spent on phone with experimental patients significantly less (P = 0.007). Metabolic control, hospitalization, psychological status, NSOne hospital-based pediatric diabetes clinicNot reportedIndividual and setting level: not reported
ATDM
Piette, 1999; Piette, McPhee et al., 1999 (randomized, controlled trial); Piette, Weinberger, and McPhee, 2000 (randomized, controlled trial)256 people in trial; proportion refusing enrollment not reported (adult, Spanish/English speakers, type 2)Less depression (P = 0.023) Greater self-efficacy (P = 0.006) Greater satisfaction with care, continuity, provider, quality of health outcome (P <0.042) HbA1c, complications, and health-related quality of life, NSTwo publicly funded health care clinicsGood; consistent and protocol driven, largely due to the ability to program telephone system. No specific implementation measures.Individual and setting level: not reported
CD-ROMs
Glasgow and Toobert, 2000 (randomized, controlled trial)320 enrolled of 419 eligible (76%) (adult, type 2)Significant improvements in all groups but not between conditions for low-fat eating (P = 0.017), fruit/vegetable consumption (P = 0.045), lowered cholesterol (P = 0.010), and lowered perception of diabetes intrusiveness (P = 0.014)HbA1c, quality of life, NS12 of 12 primary care practices approached; 40 of 42 care providers totalGood; implemented as intended with implementation scores between 80 and 99%Individual and setting level: not reported
Glasgow et al., 1997 (randomized, controlled trial)206 enrolled of 338 eligible (61%) (adult, type 2)Greater change in dietary behavior (P = 0.023), lowered cholesterol (P = 0.002), and patient satisfaction (P <0.02) than controlHbA1c, NSTwo primary care provider practicesGood; authors concluded that registered dietitians and/or nurses could implement the intervention.Effects consistent at 1-year follow-up. Cost of intervention $137 per patient. Setting level: not reported
Internet
McKay et al., 1998 (convenience sample)Eligibility unknown from Internet; 111 enrolled (adult, type 2)Most frequently accessed components: social support group (60%); diabetes information (36%). Limited use of SMBG recording by participantsOne Website, 111 usersGood; consistent and protocol driven, largely due to the ability to program Web pages on the Internet. No specific implementation measures.Individual and setting level: not reported
Barrera et al., 2000; Feil et al., 2000 (randomized trial)160 enrolled of 265 eligible (61%) (adult, type 2 novice computer users)Increased perception of social support among those using Internet social support options (P <0.017). Physiological changes not measured16 primary care practices for recruitment (90%); study implementation in individual homesGood; participants accessed Internet through computers provided by study. No specific implementation measures.Individual and setting level: not reported