Text-Messaging as Effective as Medication for Improving Type 2 Diabetes?
The findings highlight the need for support and accountability in living with diabetes
Diabetes can be a royal pain in the you-know-what. Staying healthy always requires effort, but living with diabetes and staying healthy requires extra effort. No fun. Interestingly, one study claims something quite bizarre related to diabetes managements – texting is just as good as medication at improving blood sugar levels. Hmmm. 
The Dulce Digital clinical trial found that low-income Hispanics with Type 2 diabetes who received health-related text messages daily for 6 months showed improvements in their blood glucose levels comparable to those they would have had if they were taking medication.
Athena Philis-Tsimikas, M.D., corporate vice president of Scripps Whittier, said:
“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 healthcare services.
The data from our new study proves that this an effective approach.”
About 30 million Americans have diabetes, which costs the United States more than $245 billion a year. Hispanics are at higher risk for the disease – 13.9% compared with 7.6% for non-Hispanic whites.
For the study, conducted between October 2012 and August 2014, researchers recruited 63 low-income Hispanic participants. The volunteers watched a 15-minute diabetes instructional video, and were then given a blood glucose meter and instructions on using it. All participants received access to their normal care, including voluntary visits with a primary care physician, as well as a certified diabetes instructor, and group diabetes self-management education.
The participants who were randomly assigned to the study group received 2-3 short text messages a day at the start of the trial, but received fewer as the study went on. Each individual in the study group received an average of 354 messages over the course of the research. The texts looked something like this:
- Use small plates! Portions will look larger and you may feel more satisfied after eating.
- It takes a team! Get the support you need — family, friends and support groups can help you to succeed.
- Tick, tock. Take your medication at the same time every day!
- Time to check your blood sugar. Please text back your results.
Researchers focused on a blood test called hemoglobin A1C, which measures average blood glucose during the previous 2-3 months. A normal hemoglobin A1C should be below 5.7%
- On average, the combined participant groups registered a baseline mean A1C of 9.5%.
- But 3 months later, the text group’s A1C was down to 8.5%.
- The control group still had an average A1C of 9.3%.
- At 6 months, the study group’s mean A1C remained at 8.5%, while the control group’s mean A1C registered a 4.9% mean.
If you’re a diabetic, you know that’s a huge improvement.
At the end of the trial, 96% of those in the study group said the text messages helped them to manage their diabetes “a lot.” The same percentage said that they would continue receiving the messages, if given the option. Ninety-seven percent said they would recommend the program to their friends.
In particular, those who received texts asking them to check their blood glucose and text their readings back had the most success. 
The researchers believe the significant drop in the study group’s mean A1C was the result of a higher level of engagement and participation in the program. It’s way too easy to forget to test your blood sugar.
“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.”
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