Diabetes self-management using online low carbohydrate support groups

Abstract

Adults diagnosed with type 2 diabetes experience derangements of carbohydrate metabolism and decreased sensitivity to insulin (e.g., carbohydrate intolerance) that lead to persistent hyperglycemia. Drastic restriction of carbohydrate intake (e,g,, about 20-50 grams per day) can rapidly improve glucose control. Sustainable dietary change such as carbohydrate restriction requires consistent and well-informed self-management. Ongoing support from family, friends, and peers—in-person or on-line—is a vital component of effective self-management. Social networking platforms (e.g., Facebook) host multiple support groups for adults with diabetes, including groups dedicated to very low carbohydrate dietary patterns for diabetes self-management. The purpose of this study was to describe how adults with type 2 diabetes perceived the social support they receive from Facebook’s support groups focused on very low carbohydrate ketogenic diet (VLCKD) for diabetes self-management. Four Facebook support groups agreed to post invitations for interested members to link to an electronic PsychData questionnaire. The survey included three validated instruments (e.g., online social support, dietary satisfaction, and dietary routines) and four optional open-ended questions. Respondents were 86% women, and the majority were diagnosed with type 2 diabetes. Women accessed the FBSG site more frequently than men and were slightly more satisfied with the social support interactions. The most important aspect of online social support groups was identified as belonging to a group of people with similar interests—like-minded people. The majority of respondents rated the benefits of the VLCKD as 5 (out of 5). Major themes in narrative responses to the question Why choose VLCKD? included: Research supported, effectiveness, results and health benefits, positive health markers, improved glycemic control, prevent complications, reduce or avoid medications and generally feel better. Women rated the diet as slightly more burdensome than men, and acknowledged more challenging eating situations than men. It is possible that differences in family roles and responsibilities around health and eating influence women’s support needs for changes in eating patterns. Perhaps the way we structure dietary education and ongoing support (both in person and via social media support groups) should differ for women and men.