PMID- 29884161 OWN - NLM STAT- MEDLINE DCOM- 20190613 LR - 20231105 IS - 1471-2458 (Electronic) IS - 1471-2458 (Linking) VI - 18 IP - 1 DP - 2018 Jun 8 TI - Randomised-controlled trial of a web-based dietary intervention for patients with type 2 diabetes: changes in health cognitions and glycemic control. PG - 716 LID - 10.1186/s12889-018-5640-1 [doi] LID - 716 AB - BACKGROUND: Increasing prevalence and disease burden has led to an increasing demand of programs and studies focused on dietary and lifestyle habits, and chronic diseases such as type 2 diabetes mellitus (T2DM). We evaluated the effects of a 6-month web-based dietary intervention on Dietary Knowledge, Attitude and Behaviour (DKAB), Dietary Stages of Change (DSOC), fasting blood glucose (FBG) and glycosylated haemoglobin (HbA1c) in patients with uncontrolled HbA1c (> 7.0%) in a randomised-controlled trial (myDIDeA) in Malaysia. METHODS: The e-intervention group (n = 62) received a 6-month web-delivered intensive dietary intervention while the control group (n = 66) continued with their standard hospital care. Outcomes (DKAB and DSOC scores, FBG and HbA1c) were compared at baseline, post-intervention and follow-up. RESULTS: While both study groups showed improvement in total DKAB score, the margin of improvement in mean DKAB score in e-intervention group was larger than the control group at post-intervention (11.1 +/- 0.9 vs. 6.5 +/- 9.4,p < 0.001) and follow-up (19.8 +/- 1.1 vs. 7.6 +/- 0.7,p < 0.001), as compared to the baseline. Although there was no significant difference between intervention and control arms with respect to DSOC score and glycaemic control, the e-intervention group showed improved DSOC score (199.7 +/- 18.2 vs193.3 +/- 14.6,p = 0.046), FBG (7.9 +/- 2.5 mmol/L vs. 8.9 +/- 3.9 mmol/L,p = 0.015) and HbA1c (8.5 +/- 1.8% vs. 9.1 +/- 2.0%,p = 0.004) at follow-up compared to the baseline, whereas such improvement was not seen in the control group. CONCLUSIONS: Most important impact of myDIDeA was on the overall DKAB score. This study is one of the first to demonstrate that an e-intervention can be a feasible method for implementing chronic disease management in developing countries. Concerns such as self-monitoring, length of intervention, intense and individualized intervention, adoption of other domains of Transtheoretical Model and health components, and barriers to change have to be taken into consideration in the development of future intervention programs. TRIAL REGISTRATION: ClinicalTrials.gov NCT01246687 . FAU - Ramadas, Amutha AU - Ramadas A AUID- ORCID: 0000-0002-8238-9659 AD - Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor Darul Ehsan, Malaysia. amutha.ramadas@monash.edu. FAU - Chan, Carina Ka Yee AU - Chan CKY AD - School of Psychology, Australian Catholic University, Brisbane, Australia. FAU - Oldenburg, Brian AU - Oldenburg B AD - Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia. FAU - Hussein, Zanariah AU - Hussein Z AD - Department of Medicine, Putrajaya Hospital, Putrajaya, Malaysia. FAU - Quek, Kia Fatt AU - Quek KF AD - Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor Darul Ehsan, Malaysia. LA - eng SI - ClinicalTrials.gov/NCT01246687 GR - D43 TW008332/TW/FIC NIH HHS/United States GR - MED2009-CM (SG)-004-QKF/Monash University Malaysia/International GR - D43TW008332/TW/FIC NIH HHS/United States PT - Journal Article PT - Randomized Controlled Trial DEP - 20180608 PL - England TA - BMC Public Health JT - BMC public health JID - 100968562 RN - 0 (Glycated Hemoglobin A) SB - IM MH - Adult MH - Diabetes Mellitus, Type 2/*diet therapy MH - Diet/*psychology/statistics & numerical data MH - Feasibility Studies MH - Female MH - Glycated Hemoglobin/analysis MH - Health Knowledge, Attitudes, Practice MH - Health Promotion/*methods MH - Humans MH - *Internet MH - Malaysia MH - Male MH - Middle Aged MH - Patient Education as Topic/*methods MH - Program Evaluation PMC - PMC5994015 OTO - NOTNLM OT - Diabetes mellitus, type 2 OT - Diet therapy OT - Randomised-controlled trial OT - Telemedicine COIS- ETHICS APPROVAL AND CONSENT TO PARTICIPATE: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Written informed consent was obtained from all individual participants included in the study. The study has obtained the ethical clearance from the Malaysian Ethics Research Committee (NMRR-09-303-3416) and Monash University's Human Research Ethics Committee (CF09/1583-2,009,000,877). COMPETING INTERESTS: The authors declare that they have no competing interests. PUBLISHER'S NOTE: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. EDAT- 2018/06/10 06:00 MHDA- 2019/06/14 06:00 PMCR- 2018/06/08 CRDT- 2018/06/10 06:00 PHST- 2017/10/18 00:00 [received] PHST- 2018/05/30 00:00 [accepted] PHST- 2018/06/10 06:00 [entrez] PHST- 2018/06/10 06:00 [pubmed] PHST- 2019/06/14 06:00 [medline] PHST- 2018/06/08 00:00 [pmc-release] AID - 10.1186/s12889-018-5640-1 [pii] AID - 5640 [pii] AID - 10.1186/s12889-018-5640-1 [doi] PST - epublish SO - BMC Public Health. 2018 Jun 8;18(1):716. doi: 10.1186/s12889-018-5640-1.