Improving Glycemic Control With a Standardized Text-Message and Phone-Based Intervention: A Community Implementation.

Area of Science:

• Digital Health
• Endocrinology
• Diabetes Management

Background:

• Type II diabetes mellitus (T2DM) poses a significant health burden in the US.
• Effective outpatient glycemic control for T2DM remains a challenge.
• Telemedicine offers potential as an adjunct therapy for glycemic management.

Purpose of the Study:

• To evaluate the effectiveness of EpxDiabetes, a novel digital health intervention.
• To assess improvements in hemoglobin A1c (HbA1c) and fasting blood glucose (FBG).
• To determine the impact on patients with uncontrolled diabetes.

Main Methods:

• 396 T2DM patients with HbA1c >7% were recruited from a community clinic.
• An automated system monitored patient-reported FBG via calls or texts.
• Care managers received alerts for elevated FBG, enabling timely follow-up.

Main Results:

• EpxDiabetes achieved high patient engagement, with response rates of 95.6% monthly and 71.1% weekly.
• A significant HbA1c reduction of -1.15% was observed over 4 months for patients with baseline HbA1c >8%.
• This contrasts with a minimal change of -0.005% in the pre-intervention period (P=.0018).

Conclusions:

• EpxDiabetes effectively reduces HbA1c in T2DM patients with high baseline levels (>8%).
• The intervention demonstrates sustained patient engagement for at least six months.
• Digital health tools can support outpatient glycemic control in T2DM management.