F E A T U R E A R T I C L E The Effects of Web-Based Diabetes Education on Diabetes Care Results A Randomized Control Study ELIF U ¨ NSAL AVDAL, PhD, BSN, RN SEVGI KIZILCI, PhD, BSN, RN NESLIHAN DEMIREL, PhD Diabetes is a chronic disease that results in morbidity and death. It is predicted that the incidence of diabetes, which is one of the most common chronic diseases, will increase rapidly worldwide in the next 20 years, and 171 million people will have diabetes. 1 According to the results of the Turkey Diabetes Epidemiology Study reported by Satman et al, 2 in Turkey, there are 2.6 million people with diabetes and 2.4 million people with glucose intolerance. In diabetes management, education of the individual with diabetes and continuity of this education are important. 3,4 In recent years, Internet use has become a more common avenue for the education of individuals with diabetes because information, when needed, is easily accessible and the cost is low; thus, Internet use has been encouraged. 5–17 In Turkey, monitoring and treatment of individuals with diabetes are carried out in polyclinics, which is a place where outpatients are treated. Most of the time, individ- uals with diabetes do not regularly attend health checks and are not monitored by health personnel. This lack of regular checkups stems from the fact that the polyclinic environment is crowded, and individuals with diabetes cannot reach the diabetes team whenever they need to. With the establishment of a Web site that will maintain diabetes training and monitoring on the Internet, individ- uals with diabetes could communicate with a healthcare provider whenever they want to and get the necessary support needed for diabetes self-care behavior. As in all parts of the world, in Turkey, Internet use is becoming more common. In the Household Information Study conducted in the Seven Regions of Turkey, com- pleted in April 2008, it was found that 24.5% of the families surveyed used the Internet. 18 This rate implies that the number of people using the Internet cannot be CIN: Computers, Informatics, Nursing & February 2011 101 CIN: Computers, Informatics, Nursing & Vol. 29, No. 2, 101–106 & Copyright B 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins This study aimed to test the effects of providing Web-based diabetes education to individuals with type 2 diabetes on the A 1c level and health check attendance. The study participants comprised 122 individuals with type 2 diabetes, who had access to the Internet, had completed their basic diabetes education, and had similar basic situational fac- tors. Using a randomization method, these par- ticipants were chosen from the patients being monitored by the diabetes nurses. The experimen- tal group (n = 61) was monitored via the Web. From measurements recorded in the sixth month of monitoring, we found that A 1c levels of the indi- viduals with diabetes who were monitored through the Web decreased (t = 6.63; P G .05), and the rate of attending health check visits increased (z = 5.97; P G .05), while no difference was detected in the control group (t = j0.63; P = .534; z = j0.80; P = .426). To maintain glycemic control, Web use could be adopted as a complementary tool for monitor- ing individuals with diabetes. KEY WORDS A 1c & Diabetes education & Health check & Internet & Web-based education I N T E R N A T I O N A L Author Affiliations: Department of Internal Medicine Nursing, School of Health, Uludag ˘ University, Go ¨ru ¨ kle, Bursa (Ms Avdal); School of Nursing Department of Internal Medicine, Dokuz Eylu ¨ l University, Balc ¸ ova, I ˙ zmir (Dr Kizilci); Department of Statistics, Dokuz Eylu ¨ l University Faculty of Arts and Sciences, TNnaztepe, I ˙ zmir (Dr Demirel), Turkey. This study took an award of first oral presentation and good re- search at International Internal Medicine Congress in Antalya, Turkey (September 30 to October 4, 2009). Dokuz Eylu ¨l University Scientific Research Project Directorate was applied for financial support, and the necessary financial support was granted. Corresponding author: Elif U ¨ nsal Avdal, PhD, BSN, RN, Depart- ment of Internal Medicine Nursing, School of Health, Uludag ˘ Univer- sity, Go ¨ru ¨kle, Bursa, Turkey (elifavdal@uludag.edu.tr). DOI: 10.1097/NCN.0b013e3181fcbdc6 Copyright @ 201 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. 1