Learning in a Virtual Environment to Improve Type 2 Diabetes Outcomes: Randomized Controlled Trial

Area of Science:

• Health Informatics
• Behavioral Medicine
• Endocrinology

Background:

• Type 2 diabetes mellitus (T2DM) self-management is crucial, yet education programs face access and adherence barriers.
• Virtual diabetes self-management education and support are increasingly utilized.
• The Diabetes Learning in a Virtual Environment (LIVE) study addresses these challenges.

Purpose of the Study:

• To compare the effects of the LIVE virtual intervention against a control website on diet and physical activity in adults with T2DM.
• To evaluate behavioral and metabolic outcomes over a 12-month period.
• To assess the efficacy of immersive virtual environments for diabetes self-management.

Main Methods:

• A 52-week multisite randomized controlled trial involving 211 adults with T2DM.
• Participants were randomized to either the LIVE virtual environment or a control website.
• Data collected via surveys, clinical measures, lab tests, and Fitbit at baseline and 3, 6, 12 months.

Main Results:

• The LIVE group showed significantly greater weight loss compared to the control group (P=.04).
• Both groups demonstrated increased physical activity and decreased HbA1c, blood pressure, cholesterol, and triglycerides.
• Clinically relevant metabolic improvements were observed in participants with baseline HbA1c >8.6% in both groups.

Conclusions:

• Both virtual and website-based interventions yielded minor positive changes in glycemic control over 12 months.
• Significant metabolic improvements occurred in participants with higher baseline HbA1c levels, regardless of intervention type.
• A comprehensive toolkit with diverse services is recommended for future T2DM self-care improvement.