Motivational text messaging programmes help in improving blood sugar control in patients with diabetes and coronary heart disease, a study has found. 

The study was presented at the 'ESC Congress 2019'. "The effect in this study was not only statistically significant but also has the potential to be clinically relevant by reducing risk of diabetic complications and death," said study's author Dr. Xiqian Huo of the Fuwai Hospital, Beijing, China. "Capitalising on the exponential growth in mobile phone usage over the past decade, a simple text-messaging programme could increase the reach of diabetes self-management support," she added. "It may provide a means to better address the burgeoning healthcare demand-capacity imbalance." 

The study enrolled 502 patients from 34 clinics in China. In addition to usual care, patients were randomly assigned to the text messaging intervention or a control group for six months. The intervention group received six messages per week, at random times of day, from an automated system set up by the researchers. Topics included diabetes and coronary heart disease, glucose monitoring and control, blood pressure control, medication adherence, physical activity, and lifestyle recommendations on diet, foot care, and emotional management. The control group received two thank you text messages per month. 

At six months, blood glycated hemoglobin (HbA1c) was significantly lower in the intervention group compared to the control group (6.7 percent versus 7.2 percent). On average, HbA1c fell by 0.2 percent in the intervention group and rose by 0.1 percent in the control group - a difference of 0.3 percent between groups. 

To reduce the complications of diabetes, the target HbA1c is less than 7 percent. Significantly more participants in the intervention group achieved the target (69.3 percent) compared to the control group (52.6 percent). The change in fasting blood glucose was larger in the intervention, compared to control, group (-0.5 versus 0.1 mmol/L, respectively). Systolic blood pressure, low-density lipoprotein (LDL) cholesterol, body mass index, and self-reported physical activity did not differ between groups. The intervention was acceptable to participants, most of whom (97 percent) found the text messages useful, readable, and an appropriate method of contact. 
While the study did not measure which text messages were most effective, Dr. Huo said, "Lifestyle advice such as strict dietary control may have contributed to glycaemic improvements, together with reminders to monitor blood glucose regularly. The messages were designed to provide information and motivation, and help patients set goals and manage stress."