Objective: Online wellness programs offer a convenient way for newly diagnosed patients to engage with targeted health education and self-management tools, but there is limited evidence on use rates and user characteristics. We examined patient characteristics associated with use of an online diabetes self-management program among patients with a new diabetes diagnosis in a large integrated health system.

Research Design and Methods: A diabetes self-management program was introduced on the health system's patient portal website in 2010 without formal clinician promotion. Using the health system clinical diabetes registry, we identified patients newly diagnosed with diabetes in 2010-2018 and examined the use of diabetes care tool in the same year they joined the registry. We examined use of the online diabetes program and used multivariable logistic regression model to examine the association between use and patient characteristics including age, gender, race/ethnicity, neighborhood socioeconomic status (SES) and baseline HbA1c.

Results: Among 277,032 total patients diagnosed with diabetes 2010-2018, 1,734 (0.63%) patients used the diabetes management program in that same year. Patients of older age (OR=0.34, 95% CI: 0.27-0.43 for age 75+ vs. <45), male (OR=0.48, 95% CI:0.44-0.53), non-white (e.g., OR=0.32, 95% CI: 0.28-0.37 for Asian vs. white), living in a low SES neighborhood (OR=0.71, 95% CI: 0.63-0.81) were less likely to use the online diabetes wellness program. Patients with higher baseline HbA1c were more likely to use the program (OR=1.29, 95% CI: 1.04-1.59 for A1c 9+ vs. A1c <7).

Conclusions: Few newly diagnosed diabetes patients used the diabetes management program on their own, with evidence of a digital divide in use. It is encouraging, however, that patients with higher baseline A1c were more likely to use the program. Efforts to promote patient-facing online tools use in clinical care delivery from providers may increase use, and research is needed on clinical impacts.


J. Huang: None. I. Graetz: None. M. Reed: None.


National Institute of Diabetes and Digestive and Kidney Diseases

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