In patients with prediabetes, the use of text message support may be conducive to clinically significant weight loss, according to study findings published in Diabetes Care.
Henry H. Fischer, MD, of the adult primary care department at Denver Health and Hospital Authority, and colleagues evaluated 163 English- and Spanish-speaking adult patients recruited from Sam Sandos Westside Family Health Center, part of the Denver Health integrated health care system. Patients did not have diabetes, their HbA1c values ranged from 5.7% to 6.4% and their BMI was 25 kg/m2 to 50 kg/m2. They also had mobile phones with text message capability.
Henry H. Fischer
Participants were randomly assigned to a text message-supported intervention (n = 78) or a control group (n = 79). The intervention involved a schedule of six text messages per week, grouped around a Diabetes Prevention Program (DPP) curriculum theme. The messages fell into the following categories: skill teaching, motivation, stress reduction, specific recipes, links to additional website resources and activity promotion messages. The control group, similar to the intervention group, had access to all standard-of-care weight-loss resources at Denver Health, including DPP classes and appointments with a nutritionist or nurse, but did not receive text messages. Participants were weighed at baseline and at 6 and 12 months.
Researchers found that mean weight reduction was 0.6 lb in the control group vs. 2.6 lb in the intervention group (P = .05). Seventeen patients in the control group lost 3% of baseline weight vs. 30 in the intervention group (P = .02). No significant difference was seen in 5% decrease in weight from baseline.
In the control group, there was an increase in mean HbA1c by 0.19%, whereas in the intervention group, HbA1c decreased by 0.09% (P = .07). A greater percentage of the intervention group (22%) demonstrated a decrease in HbA1c greater than the absolute 6% variance of the HbA1c assay vs. controls (7%; P < .05).
When participants were stratified by language, the researchers found a significant treatment effect among Spanish-speaking participants, but not among English-speaking participants. The number of Spanish speakers needed to treat to achieve 3% weight loss was four.
“This study adds to a growing virtual DPP literature by examining pure text message support over 12 months in a safety net population,” Fischer told Endocrine Today. “It shows promise for a low cost, scalable approach that merits further exploration in operational settings and across diverse patient populations.” – by Jennifer Byrne
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Henry H. Fischer, MD, can be reached at email@example.com.
Disclosure: The researchers report no relevant financial disclosures.