Message sent: SMS intervention improves glucose control in diabetics

For patients with type 2 diabetes mellitus (T2DM), receiving text messages containing educational information or treatment reminders may help reduce HbA1c levels and improve medication adherence for at least 6 months, according to a meta-analysis.

Researchers searched multiple online databases for relevant studies. The search yielded 70 studies, of which 10 were included in the meta-analysis. Four studies had a pre-post design, and six were randomized controlled trials. The inclusion criteria for the intervention group were as follows: T2DM diagnosis, use of oral glucose-lowering drugs or self-injection insulin, and ability to read short messaging service (SMS) on a mobile phone or to be with someone who could read SMS.

The total population included 655 T2DM patients: 380 in the intervention group and 275 in the control group. Pooled data showed that following an SMS intervention, HbA1c significantly decreased from baseline (standardized mean difference [SMD], −0.49, 95 percent confidence interval [CI], −0.75 to −0.22; I2, 64.90 percent; p=0.002). Glucose control remained satisfactory at 3 and 6 months after the intervention (SMD, −0.29, 95 percent CI, −0.53 to −0.22 and SMD, −1.14, 95 percent CI, −2.12 to −0.17, respectively).

Likewise, the intervention improved medication adherence from baseline (SMD, 0.96 percent, 95 percent CI, 0.45–1.47; I2, 56.40 percent; p=0.10). This finding points to the importance of adherence in achieving therapeutic goals, the researchers said.

Taken together, the present data indicate that SMS is a feasible intervention to control HbA1c level in T2DM for at least 6 months, they added. Improved compliance of patients may be achieved over a longer period by enriching the content of the SMS, adding a new method of intervention such as e-mail or telephone calls, or by strengthening feedback.