"Sweet Talk": text messaging support for intensive insulin therapy for young people with diabetes

Optimal diabetes management involves considerable behavioural modification, while nonadherence contributes significantly to poor glycaemia. Extensive research on psychological interventions aiming to improve glycaemia suggests that current strategies are costly and time-consuming and in our experience do not appeal to young people with Type 1 diabetes. Text messaging has rapidly become a socially popular form of communication. It is personal, highly transportable, and widely used, particularly in the adolescent population. However, text messaging coupled with specific behavioural health strategies has yet to be utilised effectively. We have developed a novel support network ("Sweet Talk"), based on a unique text-messaging system designed to deliver individually targeted messages and general diabetes information. Individualised motivation strategies--based on social cognition theory, the health belief model, and goal setting--form the theoretical basis of the message content. Intensifying insulin therapy and increasing contact with the diabetes team can improve control, but are difficult to provide within existing resources. Our support system offers a means of contact and support between clinic visits and aims to increase adherence with intensive insulin regimens and to improve clinical outcome.