Evaluation of Support, a self-guided online type 1 diabetes self-management education and support web application-a mixed methods study

Background: Type 1 diabetes requires making numerous daily decisions to maintain normoglycemia. Support is an evidence based self-guided web application for type 1 diabetes diabetes self-management. Objective: Evaluate users' satisfaction with Support and investigate changes in self-reported frequency of-, fear of- hypoglycemia, and diabetes-related self-efficacy. Methods: Adults from a Quebec type 1 diabetes registry used Support. Data was collected through online surveys or extracted from the registry at 0, 6, and 12 months (number of episodes and fear of hypoglycemia). At 6 months, participants reported satisfaction with Support and diabetes-related self-efficacy. A sub-group of 16 users was interviewed about their experience. Transcripts were analyzed using inductive and deductive approaches. Results: In total, 207 accounts were created (35% men, 96% White, mean age and diabetes duration: 49.3 +/- 13.8 and 25.2 +/- 14.7 years). At 6 months, the median [Q1; Q3] satisfaction was 40/49 [35; 45] with a mean decrease in hypoglycemia frequency of 0.43 episodes over 3 days (95% CI: -0.86; 0.00, p=0.051) and of -1.98 score for fear (95% CI: -3.76; -0.20, p= 0.030). Half of the participants reported increased diabetes-related self-efficacy. Conclusions: Participants reported a high level of satisfaction with Support. Its use has the potential to facilitate hypoglycemia management and increase diabetes-related self-efficacy.