Teaming up: feasibility of an online treatment environment for adolescents with type 1 diabetes

Objective: To evaluate the feasibility of an online interactive treatment environment for adolescents with type 1 diabetes, called Sugarsquare, to supplement usual care. Research design and methods: Sugarsquare provides easily accessible contact with the diabetes team, peer support, and treatment overview. Of 120 eligible patients, 62 adolescents aged 11-21 (M=15.23, SD=2.00) were assigned to a usual-care group (n=31) or a usual-care+ intervention group (n=31). Feasibility was assessed in terms of acceptability, demand, practicability, integration, and efficacy in a 9-month study-period. Results: Assessment of acceptability and demand revealed that 20 adolescents in the intervention group (65%) logged in at least once; 16 adolescents (52%) logged in repeatedly. Usage resulted in 5795 page-views, 3580 chat-messages, 427 forum-messages, and in 40 private interactions between 11 adolescents (35%) and professionals. Assessment of practicability revealed that all 13 professionals (100%) accessed the intervention. Slow processing speed and security procedures formed obstacles for usage. Assessment of integration showed that international standards for diabetes care (International Diabetes Federation/International Society for Pediatric and Adolescent Diabetes/American Diabetes Association) were met. Assessment of efficacy revealed improvement in the intervention group in evaluation of care (Patients' Evaluation of Quality of Diabetes), F(1,30)=5.35, p < 0.05, and quality of life, communication (PedsQL), F(1,30)=11.65, p < 0.05. The latter was correlated with posted chat-messages (r=0.42, p < 0.05). No between-group differences were found. Conclusions: This study shows that Sugarsquare is feasible in adolescents with type 1 diabetes. It meets a demand in adolescents and can support professionals when organizing on-going care according to international standards. Results are promising and next steps are a full-scale randomized controlled trial and subsequent implementation in daily care.