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The purpose of this study was to investigate the effectiveness of a Web-based intervention on self-reported blood sugars for older adults with diabetes. Participants who were randomized in the first phase to the intervention group (n = 15) aged 60 and older with diabetes accessed a study Web site that provided them access to an on-line library, advice and counseling from a nurse via e-mail, a personal electronic log of self-management activities, and weekly on-line problem-solving group discussions. Longitudinal mixed-effects modeling was used to investigate the effects of the Web-based intervention on blood sugar levels over a 6-month period. Participants who had fewer than six self-reported medical comorbidities (n = 8) at baseline were more likely to experience a linear decline on blood sugar levels than participants reporting more than six comorbidities. A significant interaction appeared among the time of day blood sugar readings were reported, baseline A1c, and the number of comorbidities. Participants who had more than six comorbidities (n = 7) experienced increased blood sugar levels over the study period, specifically with AM fasting and before bedtime reporting times. Participants with fewer than six comorbidities experienced a decline in blood sugar levels during the same testing times. Findings show that a Web-based intervention was not effective in improving blood sugar readings among adults with six or more comorbidities at baseline. Future research needs to further investigate the role comorbidities may play with the outcomes of Web-based interventions.
Bond et al. (Fri,) studied this question.