Clinical Edge

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Glucose Control is Not a Game–Or Is It?

Diabetes Care; ePub 2017 Aug 8; Kerfoot, et al

An online game that delivers diabetes self-management education (DSME) resulted in continuous HbA1c improvements, according to a randomized trial involving 456 individuals.

Participants with HbA1c ≥58 mmol/mol and taking oral diabetes medications were randomly assigned to either a DSME team-based game and an accompanying civics booklet or a civics game with a DSME booklet for 6 months. The games sent 2 questions twice weekly, awarded points based on performance, and provided modest financial rewards. Investigators looked at HbA1c change over 1 year. Among the results:

  • Patients who played the DSME game saw their HbA1c reduced by −8 mmol/mol, compared with −5 mmol/mol for those in the other group.
  • HbA1c reductions were greater in patients with baseline levels >75 mmol/mol: −16 mmol/mol in DSME game players, and −9 mmol/mol in civics game players.

The authors noted that the DSME game approach may work particularly well for geographically dispersed patients.


Kerfoot B, Gagnon D, McMahon G, Orlander J, Kurgansky K, Conlin P. A team-based online game improves blood glucose control in veterans with type 2 diabetes: A randomized, controlled trial. [Published online ahead of print August 8, 2017]. Diabetes Care. doi:10.2337/dc17-0310.