A pilot project for improving paediatric diabetes outcomes using a website: the Pediatric Diabetes Education Portal

Abstract

We created a website for patients and families that allowed them to review clinic test results, review educational materials related to these results and post questions to their diabetes educator. Fingerstick haemoglobin A1c (HbA1c) testing and periodic use of a continuous glucose monitoring system (CGMS) were offered to all patients. The HbA1c and CGMS results were posted to the website after each clinic visit. A total of 52 patients with type 1 diabetes were enrolled in the study. There were 16 patients with HbA1c values within ADA guidelines and 16 with HbA1c values above guidelines; 20 patients were excluded for various reasons. Users of the website were defined as families who logged in four or more times over the six-month study period. For patients whose HbA1c started above ADA guidelines, the mean HbA1c for website users decreased from 10.5% (SD 2.2) at baseline to 9.1% (SD 1.2) after six months. In the non-users, the mean HbA1c increased from 9.5% (SD 1.5) at baseline to 10.4% (SD 2.5). However, these changes were not significant. A between groups comparison (users versus non-users) showed a significant improvement in HbA1c for website users ( P = 0.03). This change in HbA1c was clinically relevant. Further studies with more patients are needed to see if these improvements can be sustained over a longer period.