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

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).