A team-based online game designed to improve diabetes self-management appears to be effective in helping patients lower their hemoglobin A1c (HbA1c), a key measure of diabetes control, according to results of a randomized controlled trial.

The reduction is similar to what would be expected from a patient that starts a new diabetes drug, according to results published this week in the US journal Diabetes Care.

For the study, researchers from Brigham and Women's Hospital and the Veterans Affairs Boston Healthcare System enrolled 456 Veteran Affairs diabetes patients from the eastern US, all of whom took oral diabetes medications but had inadequate glucose control.

Half were randomly assigned to the team-based online game, known as diabetes self-management education (DSME), while the other half were assigned to a civics education game to serve as a control group.

The DSME game presents a player with a multiple-choice question related to glucose management, exercise, long-term diabetes complications, medication adherence and nutrition.

The game also included detailed explanations for the answers, a "take-home message" and references.

Participants were sent two questions every Tuesday and Thursday by email or mobile app.

After answering the question, they were immediately presented with the correct answer and an explanation, and the same question would be sent again around four weeks later to reinforce the concept.