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Long‐term follow‐up of a randomized controlled trial of a text‐message diabetes self‐management support programme, SMS4BG

journal contribution
posted on 20.12.2020, 22:46 authored by Rosie DobsonRosie Dobson, R Whittaker, Y Jiang, C McNamara, M Shepherd, R Maddison, R Cutfield, M Khanolkar, R Murphy
© 2019 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK. Aims: To determine the long-term effectiveness of an individually tailored text-message diabetes self-management support programme, SMS4BG, on glycaemic control at 2 years in adults with diabetes with an HbA1c concentration > 64 mmol/mol (8%). Methods: We conducted a 2-year follow-up of a two-arm, parallel, randomized controlled trial across health services in New Zealand. Participants were English-speaking adults with type 1 or 2 diabetes and with an HbA1c >64 mmol/mol (8%). In the main trial participants randomized to the intervention group (N=183) received up to 9 months of an automated tailored text-message programme in addition to usual care. Participants in the control group (N=183) received usual care for 9 months. In this follow-up study, 293 (80%) of 366 randomized participants in the main trial were included. The primary outcome measure was change in glycaemic control (HbA1c) from baseline to 2 years. Mixed-effect models were used to compare the group differences at 3, 6, 9 and 24 months, adjusted for baseline HbA1c and stratification factors (health district category, diabetes type and ethnicity). Results: The decrease in HbA1c at 2 years was significantly greater in the intervention group [mean (sd) –10 (18) mmol/mol or –0.9 (1.6)%] compared with the control group [mean (sd) –1 (20) mmol/mol or –0.1 (1.8)%], with an adjusted mean difference of –9 mmol/mol (95% CI –14, –5) or –0.8% (95% CI –1.2, –0.4; P<0.0001). Conclusions: Improvements in glycaemic control resulting from a text-message diabetes self-management support programme were sustained at 2 years after randomization. These findings support the implementation of SMS4BG in current practice.


The SMS4BG 2-year follow-up study was funded by the New Zealand Society for the Study of Diabetes. Waitemata District Health Board funded the development of SMS4BG. The Health Research Council of New Zealand, in partnership with Waitemat~a District Health Board and Auckland District Health Board (through the Research Partnerships for New Zealand Health Delivery initiative), and the New Zealand Ministry of Health funded the RCT. The funders were not involved in any way in the preparation of the manuscript or analysis of the study results.


Publication Date



Diabetic Medicine






8p. (p. 311-318)





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