A new study from Texas A&M University shows that online diabetes self-management programs can help people with type 2 diabetes significantly lower their blood sugar levels—even if they live in rural areas or have limited access to health care.
Researchers found that three different types of virtual diabetes programs helped reduce participants’ hemoglobin A1c levels, a key marker used to measure blood sugar control.
The study lasted six months and included adults from both rural and urban areas in Texas.
“There are many programs to help people manage type 2 diabetes, but few studies have looked at how the way a program is delivered affects results,” said Dr. Marcia Ory, the study’s lead author and a professor at Texas A&M School of Public Health.
The research involved 189 adults aged 25 and older, all with poorly managed type 2 diabetes. Their A1c levels at the start were 7.5 or higher, which indicates high blood sugar.
These participants came from 46 counties in Texas.
Most were white, non-Hispanic, and over half reported having poor or fair health. About one-third lived in rural areas, and nearly a quarter were men.
The study tested three types of online diabetes support over a six-month period:
- Structured virtual education and support program – This included 6–8 hours of self-paced online learning and one-on-one sessions with a nurse or dietitian. The goal was to help participants learn about diabetes and create personal plans for managing it.
- Smartphone app – This app included tools to help with daily diabetes care and a chat feature for coaching support.
- Combination of both approaches – Participants first went through the structured education and then used the smartphone app.
Each intervention lasted three months. Researchers checked participants’ A1c levels at the start, three months, and six months.
The results showed that all three types of programs helped lower A1c levels. There was no major difference in which method worked best, meaning that even the simpler smartphone app was as effective as the more structured program.
Even better, the blood sugar improvements lasted over time. The researchers said this shows that online, self-paced learning can lead to long-term health benefits.
Older adults in the study showed the biggest improvements, and people with better health at the beginning also saw more progress.
“We were pleased that 90% of participants completed the full six months, which is a high rate for studies like this,” said co-author Matthew Smith. “We think it’s because the programs were flexible and easy to follow.”
The study was done only in Texas and included English-speaking adults with internet access, so the findings might not apply to everyone. Also, COVID-19 made recruitment harder and required changes to the study design.
Still, the researchers believe many others—especially people with limited health care access—could benefit from similar online programs.
“This is hopeful news,” Dr. Ory said, “especially since type 2 diabetes is rising in the U.S. and can lead to serious health problems if not managed.”
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