A Digital Diabetes Clinic Intervention for Individuals Starting Insulin Therapy: Randomized Controlled Trial.

Abstract

This randomized controlled trial evaluated the effects of a digital diabetes clinic continuous support program on metabolic, psychological, and social outcomes in individuals with type 2 diabetes who were recently initiated on insulin therapy. The study included 67 participants, with 35 in the intervention group and 32 in the control group. Data were collected at baseline, and at the third and sixth months using various instruments, including the Diabetes Individual Diagnosis Form, Hypoglycemic Confidence Scale (HCS), Hypoglycemia Fear Survey (HFS), Diabetes Empowerment Scale-Short Form (DES-SF), Psychological Insulin Resistance Scale (PIRS), Insulin Treatment Assessment Scale (ITAS), Perceived Social Support Scale (PSSS), and the Visual Analog Scale (VAS) for stress. The intervention group received digital education, counseling, continuous follow-up, and a structured daily self-management program over a 3-month period. 99% CIs were calculated for key outcome measures to support the interpretation and robustness of the results. The findings revealed significant improvements in the intervention group, including reductions in the frequency of hypoglycemia and hyperglycemia, emergency admissions, HbA1c, and lipid levels ( P <.001). Furthermore, hypoglycemia fear and psychological insulin resistance decreased, while hypoglycemic confidence, diabetes empowerment, perceived social support, and stress levels significantly improved ( P <.001). These results demonstrate that digital support programs delivered through a digital diabetes clinic can enhance treatment adherence, reduce anxiety, and improve self-management in individuals newly started on insulin, highlighting the effectiveness of telehealth in diabetes care. Newly initiated on insulin therapy, underscoring the potential of telehealth in diabetes care.