BACKGROUND: The Internet represents a promising tool to improve diabetes care.
OBJECTIVE: To assess differences in demographics, self-care behaviors, and diabetes-related risk factor control by frequency of Internet
use.
DESIGN AND PARTICIPANTS: We surveyed 909 patients with type 2 diabetes attending primary care clinics.
MEASUREMENTS: Frequency of Internet use, socioeconomic status, and responses to the Problem Areas in Diabetes (PAID), Summary of Diabetes
Self-care Activities (SDSCA), and Health Utilities Index (HUI) scales. Survey responses were linked to last measured hemoglobin
Alc, cholesterol, and blood pressure results. Comorbidities and current medications were obtained from the medical record.
RESULTS: Internet “never-users” (n=588, 66%) were significantly older (70.0±11.2 vs 59.0±11.3 years; P<.001) and less educated (26% vs 71% with > high school; P<.001) than Internet users (n=308, 34%). There were few significant differences in PAID or SDSCA scores or in diabetes metabolic control despite longer
diabetes duration (10.3±8.2 vs 8.3±6.7 years; P<.001) and greater prevalence of coronary disease (40% vs 24%; P<.001) in nonusers. Less than 10% of current nonusers would use the Internet for secure health-related communication.
CONCLUSIONS: Older and less educated diabetes patients are less likely to use the Internet. Despite greater comorbidity, nonusers engaged
in primary care had equal or better risk factor control compared to users.
Key words Internet use - diabetes - barriers to care - chronic disease
Authors report no conflicts of interest
See Editorial by Vinicor, p. 483.
Supported by the MGH Primary Care Operations Improvement program and an unrestricted research grant from Pfizer, Inc. Dr.
Meigs is supported by an American Diabetes Association Career Development Award.