Exploring the Quality of TikTok-Based Diabetes Self-Management Education in English and Spanish: A Digital Health Study

Purpose: The purpose of this study was to evaluate TikTok videos about type 2 diabetes mellitus (T2DM) in English and Spanish, with a focus on the Association of Diabetes Care and Education Specialists’ 7 self-care behaviors (ADCES7). Methods: This descriptive study analyzed 300 TikTok videos via English and Spanish hashtags related to T2DM and categorized self-management education content utilizing the ADCES7 self-care behavior framework. Video content creators were categorized into 3 groups: health care professionals, personal accounts, and companies. The Global Quality Scale (GQS) was used to assess video quality from 1 (poor) to 5 (excellent). User engagement metrics were recorded to examine differences across videos. Results: The analysis of videos revealed that healthy eating was the most frequently addressed ADCES7 self-care behavior, followed by reducing risk. In contrast, problem-solving and healthy coping were the least represented. Spanish-language videos emphasized healthy coping more than English content. Health care professionals’ videos had higher GQS scores than personal accounts and companies. However, overall GQS scores remained low—engagement varied by source, with personal creators generating the highest levels of likes and comments. Conclusions: Traditional in-person diabetes education has limited accessibility, especially for various groups, including Hispanic communities. This study found that TikTok content often lacked high-quality and comprehensive coverage of ADCES7 self-care behaviors, with personal accounts generating the most engagement despite lower quality. Given TikTok’s rapid growth, there is an urgent need to improve the quality of diabetes-management content to ensure users receive accurate and reliable information.