The effects of shared decision-making informed dietary intervention based on digital health technology in older adults with type 2 diabetes mellitus: A randomized controlled trial

Abstract

Objectives: To evaluate the effectiveness of shared decision-making informed dietary intervention based on digital health technology, for older adults with type 2 diabetes mellitus and determine its impact on patients' glycemic control (hemoglobin A1c (HbA1c) and fasting plasma glucose), physical indicators (blood pressure and body mass index), self-management behavior, and self-efficacy.

Design: A double-arm-randomized controlled trial using a parallel group design was conducted.

Participants: 124 older adults with type 2 diabetes mellitus recruited from the endocrinology department or diabetes clinics were randomly assigned to the intervention (n = 64) or control group (n = 60).

Interventions: Patients in the intervention group received shared decision-making informed dietary intervention through the digital health system and those in the controlled group received routine dietary management.

Primary and secondary outcome measures: The primary outcome was HbA1c, and the secondary outcomes were fasting plasma glucose, blood pressure, body mass index, self-management ability, and self-efficacy.

Results: After 3 months of intervention, compared to the control group, the intervention group showed a statistically significant decrease in HbA1c, diastolic blood pressure, and fasting plasma glucose (P < 0.05). After the intervention, there were time, group main effects, and interaction effects on diabetes self-management ability and diabetes self-efficacy scores of older adults with type 2 diabetes mellitus (P < 0.05).

Conclusions: The intervention program based on a digital health system significantly improved glycemic control and enhanced self-care ability in older adults with type 2 diabetes mellitus.

Practice implications: Clinicians can integrate digital health technology in behavior change intervention, especially in older adults with chronic disease.

Trial registration: It was registered and approved by the China Clinical Trials Center (ChiCTR2300071455).

Keywords: Shared decision-making; diabetic diet; digital health; gerontological nursing; randomized controlled trial; type 2 diabetes mellitus.

Figure 1.

The diagrammatic sketch (a) and framework (b) of shared decision-making (SDM)-informed dietary intervention based on digital health technology.

Figure 2.

Flow diagram.