Effect of an eHealth care programme on metabolic control and empowerment among adolescents with type 1 diabetes mellitus: a quasi-experimental study

Abstract

Abstract Background: Type 1 diabetes mellitus (T1D) is the most common chronic endocrine disease among children and adolescents. Most adolescents have suboptimal glycaemic control and encounter difficulties in achieving and maintaining their target glycaemic control. This study tested the effect of a novel eHealth care programme on metabolic control and empowerment compared with the usual care among adolescents with T1D. Method: A 1-year quasi-experimental study was carried out. A total of 51 adolescents (13-16 years of age) with T1D and unsatisfactory glycaemic control (HbA1C > 57mmol/mol) were included in the study from two paediatric diabetes clinics in South Sweden. The participants were assigned to the intervention group (n=18) to receive the eHealth care programme and a matched comparison group (n=33) was taken from the National Diabetes Quality Register. Participants' changes in glycaemic control metrics between the two groups and changes in the level of empowerment among the intervention group over time as measured with the Gothenburg Young Persons Empowerment Scale (GYPES) were computed. Results: The mean age of the study participants was 14.96 years (±1.13SD) and 58.82 % (n=30) were females. During the intervention period, the mean percent time above range (% TAR) was lowered from 70.00 % to 57.43 % among the intervention group. A significant reduction in time spent in hyperglycaemia was observed in the intervention group compared with the comparison group (p < 0.001). Although not statistically significant, the mean value of the percent time in range (%TIR) increased from 26.87 % to 29.31% among the intervention group (p = 0.660). However, no significant change was observed in the remaining glycaemic control metrics between the two study groups. A significant change in the total GYPES score over time was observed among the intervention group (p = 0.002). Conclusion: Our study shows that the eHealth care programme significantly reduced %TAR and improved empowerment scores among adolescents with T1D, indicating that the intervention could be useful and effective in supporting adolescents with unsatisfactory glycaemic control. However, a randomized study with a large sample size is needed to confirm the observed and long-term effects of our intervention.