Clinical guidelines about diabetes and the accuracy of peer information in an unmoderated online health forum for retired persons

The objective of this study was to determine whether peer recommendations made in response to user queries about non-insulin dependent type II diabetes in an online health forum for retired persons were in agreement with diabetes clinical practice guidelines. A content analysis was conducted on type II diabetes conversations occurring in an online health forum for Canadian retired persons from 1 January to 31 December 2006. Recommendations responding to posted questions about diabetes were compared with published Canadian diabetes clinical practice guidelines. Seven diabetes-related questions generated 17 responses and 35 recommendations. Comparison of recommendations with evidence-based sources indicated that 91% (32,135) were in agreement with the best practice clinical guidelines for type H diabetes. Discussion themes included diabetic signs and symptoms, glycemic control, neuropathy, retinopathy, diet and physical activity recommendations and interactions of prednisone with glucose control. Concerns about the accuracy of online peer recommendations about type II diabetes care and management have not supported these results. This forum presents information sharing among a group of knowledgeable older adults with high interactive health literacy skills. Future research is needed to determine whether deviations from 'accurate' online information are truly harmful or represent lay expert adaptations to self-care routines.