Text message reminders for adolescents with poorly controlled type 1 diabetes: A randomized controlled trial

Area of Science:

• Endocrinology
• Pediatrics
• Digital Health

Background:

• Adolescents with type 1 diabetes often struggle with treatment adherence, increasing complication risks.
• Glycemic control is a critical factor in managing type 1 diabetes and preventing long-term health issues.

Purpose of the Study:

• To evaluate the impact of Short Messaging Service (SMS) reminders on glycemic control in adolescents with type 1 diabetes.
• To assess the feasibility and patient satisfaction of using SMS for diabetes management support.

Main Methods:

• A randomized controlled trial involving adolescents aged 12-21 years with type 1 diabetes and elevated HbA1c levels (≥ 69 mmol/mol).
• The intervention group received daily SMS reminders for insulin injections, while the control group received standard care.
• Data were analyzed using intent-to-treat and per-protocol approaches over a 6-month period.

Main Results:

• The SMS group showed a trend towards lower median HbA1c levels (73 mmol/mol) compared to the control group (83 mmol/mol) in intent-to-treat analysis (P=0.03).
• A significant proportion of patients with baseline HbA1c ≥ 80 mmol/mol achieved at least a 1% decrease in HbA1c in the SMS arm (60%) versus the control arm (30.6%) (P=0.03).
• Patients in the SMS arm reported high satisfaction with the intervention.

Conclusions:

• SMS interventions show a promising trend for improving glycemic control in adolescents with poorly controlled type 1 diabetes.
• Further research is needed to address methodological limitations and confirm the efficacy of SMS-based support for behavior change in this population.