Can Texting Interventions Help Type 2 Diabetes Management?

At the 2014 American Diabetes Association conference, Maria Isabel Garcia, NP presented preliminary data from Project Dulce’s text-messaging based intervention, “Dulce Digital” in San Diego, CA. The study looked at a group of Latinos with poorly controlled type 2 diabetes, low income, and low health literacy. The intervention had two arms: a control group, in which patients continued with their normal clinical care, and the Dulce Digital intervention, in which patients received around two to three text messages per day containing motivational or educational diabetes content. Patients could respond to these texts indicating the message had been received and read. According to the preliminary results, patients in the Dulce Digital arm who responded to texts concerning the topic of blood glucose saw an average 1% drop in A1c from a baseline of 9.5% maintained over a six-month period. As one would expect, the number of text responses correlated with better outcomes; too few texts back was associated with a weaker A1c reduction.

The Latino population is a critical one to study, as Latinos have a two-fold greater risk of type 2 diabetes, suffer more complications and hospitalizations, and have an increased mortality rate compared to non-Latino whites. Though the results of this study are preliminary, given that 91% of the US population owns a cell phone, interventions such as Dulce Digital could offer promising potential for improving diabetes care, particularly (but not limited to those) in those who do not have access to healthcare providers or diabetes medications. –AJW