The Dulce Digital clinical trial is the first randomised controlled study to look at the use of text messages to help these patients better self-manage their diabetes through glycemic control.
“As a low-cost intervention, we believe text messaging has great potential to improve the management of diabetes, especially among patients who struggle, due to employment, transportation and other barriers, to access health care services,” said Athena Philis-Tsimikas, vice president of Scripps Whittier.
Diabetes affects 29.1 million Americans and costs more than $245 billion a year to treat, according to the American Diabetes Institute. Hispanics face a higher risk of developing the disease, at 13.9 per cent compared with 7.6 per cent for non-Hispanic whites.
The study conducted between October 2012 and August 2014 recruited with 126 participants in clinics operated by Neighborhood Healthcare, a non-profit community health organisation, in the Southern California counties of San Diego and Riverside.
All participants watched a 15-minute diabetes educational video, received a blood glucose meter and instructions on using it, and were given access to usual care.
The 63 participants who were randomly assigned to the study group received two to three short text messages a day at the beginning of the trial, which tapered off slightly over the next six months. On average, each participant received 354 messages over the course of the study. The texts covered a range of educational, motivational and actionable messages.
The study focused on haemoglobin A1C, a blood test that measures average blood glucose during the previous two to three months. For people who do not have diabetes, a normal A1C level is below 5.7 percent.
At the start of the Dulce Digital study, the combined participant groups registered a baseline mean A1C of 9.5 percent. After three months, the mean A1C for the group receiving the texts had improved to 8.5 percent while the control group had a mean A1C of 9.3 percent. At six months, the study group’s mean A1C was still 8.5 per cent while the control group registered a 9.4 per cent mean.
After the trial ended, 96 per cent of the study group participants said the text messages helped them to manage their diabetes. The same number said they would continue receiving text messages if given the choice, and 97 per cent said they would recommend the programme to friends and family members.
Researchers also found that participants who texted in their blood glucose levels more often had better A1C measures than participants who texted back to the researchers less frequently. They speculated that the increased text volume reflected an overall higher level of engagement and participation in the programme.
“Taken together, these findings suggest that, on a wider scale, a simple, low-cost text message-based approach like the one offered through Dulce Digital has the potential to significantly benefit many people who struggle every day to manage their diabetes and maintain their health,” Tsimikas said.
The results are published by Diabetes Care: http://care.diabetesjournals.org/search/%252BTsimikas%252B
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