mHealth Low-Carbohydrate Type 2 Diabetes Intervention Positively Impacts Sleep Quality and Psychosocial Outcomes

To examine the 3-month change of a mHealth low-carbohydrate dietary (LCD) application (app) on sleep quality and psychosocial outcomes in people living with type 2 diabetes (T2D). The aim is to understand the broader impact of the LCD app in the Australian primary care context as an adjunct to standard clinical management of T2D.

The single arm pre-post study recruited community-based people living with T2D, with web access from around Australia, referred via registered supporting general practitioners (GPs). Following informed consent, participants obtained access to the Defeat Diabetes app, which provided education and resources on the LCD approach and support for ongoing management of T2D. Participants self-reported dietary data and validated questionnaires assessed sleep quality (B-PSQI), quality of life (QoL) (EQ-5D-5L), diabetes-related distress (PAID-5), and self-efficacy in diabetes self-management (PDSMS). Univariate regression models examined changes from baseline to 3 months.

The present study included 99 participants (mean age 59 ± 11 years, 55 females). Mean carbohydrate intake reduced from baseline to 3 months as a proportion of overall energy intake (-14%kJ/day, 95% CI -17 to -11). Self-reported perceived health status (6, 95% CI 1 to 11), self-efficacy (5, 95% CI 4 to 7), and diabetes-related distress scores (-2.0, 95% CI -3 to -1) improved over 3 months, and there were nonsignificant improvements in sleep quality.

People with T2D who used a mHealth LCD app significantly improved their perceived health status, diabetes-related distress, and self-efficacy in diabetes self-management scores after 3 months.

mHealth LCD apps should be considered useful adjuncts to current medical management of T2D.