Background

Digital tools are increasingly used in diabetes care, but their long-term effectiveness remains uncertain. A previous randomized controlled trial (RCT) demonstrated promising effects on perceived burden and quality of life after 6 months. The present study extends these findings through a 12-month follow-up, aiming to evaluate the long-term effects of virtual care on glycaemic control, treatment satisfaction, and quality of life among young adults with type 1 diabetes.

Methods

This single-centre wait-list RCT included 70 young adults aged 18-25 years with type 1 diabetes in Stockholm, Sweden. Participants randomized to the intervention group had access to the virtual platform for 12 months whereas participants in the wait-list control group received access after 6 months. The platform facilitated real-time communication with healthcare providers. Glycated haemoglobin (HbA1c) levels, time in range, time below range, diabetes treatment satisfaction, and quality of life were assessed at baseline and at the 6- and 12-month follow-ups. Comparisons within and between groups were performed using Welch's paired and independent samples t-test, the Wilcoxon signed rank test, and the Mann-Whitney test.

Results

At the 12-month follow-up, the intervention group showed a decreased HbA1c level from baseline (62.8 to 58.6 mmol/mol; P = 0.051) and improved time in range (46.6% to 56.9%; P = 0.002). In the wait-list control group, social burden decreased significantly from baseline to 12 months (4.3 to 0.03; P = 0.030). Other measures of quality of life, including social and emotional health, showed no significant differences.

Conclusions

Virtual diabetes care may enhance engagement and modestly improve glycaemic control in young adults, serving as a practical complement to standard outpatient follow-up.Trial registrationISRCTN (ref: 73435627, registration date: 23/10/2019): https://doi.org/10.1186/ISRCTN73435627.