Daily texts help patients manage type 2 diabetes

Researchers are taking advantage of the reach of smartphones to help type 2 diabetes patient manage their condition. A study, published in Diabetes Care, evaluated the use of text messages in improving diabetic patients' blood sugar management.

The Dulce Digital clinical trial focused on low-income Hispanics with type 2 diabetes. Hispanics have a 13.9 percent risk of developing the chronic disease, compared to 7.6 percent for non-Hispanic whites. The trial, conducted from October 2012 to August 2014, enrolled 126 participants who were uninsured or received coverage through California's MediCal.

"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, MD, corporate vice president of Scripps Whittier Diabetes Institute. "The data from our new study proves that this an effective approach."

The study provided all participants with a 15-minute educational video, blood glucose meters with instructions, access to voluntary visits with a primary care physician, certified diabetes education and group diabetes self-management education. The 63 participants in the study group additionally received two to three test messages a day that became less frequent over the next six months. Text messages included educational, motivation and actionable messages like “Use small plates! Portions will look larger and you may feel more satisfied after eating” and “Time to check your blood sugar. Please text back your results.”

Results were measured on hemoglobin A1C counts, which are normal below 5.7 percent. At baseline, A1C levels of all participants were 9.5 percent. After three months, participants in the text message group had hemoglobin A1C levels at 8.5 percent compared to the control group at 9.3 percent. After six months, the text message group A1C was measured at 8.5 percent, while the control increased to 9.4 percent. The large majority of text message participants (96 percent) reported the messages helped manage their diabetes and 97 percent recommended the program to friends and family.

"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," Philis-Tsimikas said.