Virtual diabetes self-management interventions have demonstrated significant effectiveness in reducing blood sugar markers among participants with Type 2 diabetes, according to new research from Texas A&M University. The study found that structured education, smartphone applications, and combined approaches all yielded substantial improvements in haemoglobin A1c levels that persisted over a six-month period, regardless of delivery method.
Study evaluates virtual diabetes management approaches Researchers from Texas A&M University’s School of Public Health have found compelling evidence that online diabetes self-management programmes can help people with Type 2 diabetes significantly improve their blood sugar control. The study, published in the journal Frontiers in Public Health, evaluated three different virtual intervention approaches and found all were effective at reducing haemoglobin A1c levels – the primary marker used to diagnose and monitor diabetes.
Led by Professor Marcia Ory, the research team conducted a randomised controlled trial involving 189 adults with unmanaged Type 2 diabetes from both rural and urban areas across Texas. All participants had baseline A1c levels of 7.5 or higher at the start of the study.
“There are many self-management interventions for people living with Type 2 diabetes, but until now little research has been conducted on their effectiveness based on how they are delivered or when they are used in combination,” said Ory, Regents and Distinguished Professor with the Texas A&M School of Public Health and the Center for Community Health and Aging.
Three intervention approaches tested
The researchers compared three different intervention modalities:
The first was a structured virtual education programme with one-on-one counselling, providing 6-8 hours of asynchronous training alongside personalised sessions with registered nurses or dietitians.
The second intervention utilised a smartphone application offering diabetes self-care skills and access to a diabetes coach for personalised support.
The third approach combined both methods sequentially, adding app access to the virtual education programme.
Participants used their assigned intervention for three months, with A1c measurements taken at baseline, three months, and six months. The research team conducted an intent-to-treat analysis to evaluate the effectiveness of each approach.
Long-lasting benefits observed
The study revealed that all three intervention types successfully reduced participants’ A1c values, with no significant differences between the approaches. More importantly, the researchers found that these improvements remained stable over time.
“In contrast to other studies, however, our longitudinal analyses found that A1c levels remained lower over time, suggesting that providing self-paced training and skill development could have a lasting impact, despite the particular virtual delivery mode,” Ory noted.
The research also revealed some interesting demographic patterns. Older adults tended to experience larger reductions in A1c values compared to younger participants, and those with better baseline health generally achieved more positive outcomes.
Participant retention was remarkably high, with about 90% of subjects remaining in the study for the full six months. Professor Matthew Lee Smith, one of the study’s key researchers, suggested this could be attributed to “efforts to make the programmes adaptable and to foster engagement through interactive learning programmes.”
Implications for diabetes management
The researchers suggest that relatively inexpensive and accessible self-management interventions could help address this growing public health challenge.
While acknowledging limitations in their sample – participants were English speakers with digital technology access living in Texas – the researchers believe their findings have broader applicability.
“We expect that many people with unmanaged Type 2 diabetes – including those from underrepresented groups or who have less access to healthcare – could experience similar benefits,” Ory said.
The study offers encouraging evidence that virtual diabetes self-management programmes can effectively improve blood sugar control, potentially reducing the risk of serious diabetes-related complications including heart disease, stroke, kidney failure, and blindness.
Reference:
Ory, M., Han, G., Smith, M. L., Towne, S., Carpenter, K., & Nsobundu, C. (2025). Comparative effectiveness of diabetes self-management education and support intervention strategies among adults with type 2 diabetes in Texas. Frontiers in Public Health.
https://doi.org/10.3389/fpubh.2025.1543298
