Diabetes and Telecommunications: Study to Support Self-Management for People with Type 2 Diabetes A Randomized Controlled Trial in Mayo Hospital, Lahore
Abstract
To investigate if telecommunications can improve the quality of life among type 2 diabetics, and results could then be projected to the management of other chronic illnesses as well. The alarmingly rising prevalence of diabetes mellitus and its crippling complications in Pakistan asks for modern solutions to ensure better quality of life among patients with type 2 diabetes.
This was a single centre, two arm parallel randomized controlled trial in which two groups of 133 type 2 diabetic patients presenting to the Diabetic clinic of Mayo Hospital, Lahore were randomly assorted into intervention and control groups. Motivational text messages regarding lifestyle modifications were sent to the intervention group for a period of one month. Fasting blood glucose was the primary outcome and BMI, blood pressure and physical activity score were the secondary outcomes of our study.
In the intervention group, mean fasting blood glucose before and after intervention were 227.8 mg/dL and 243.71 mg/dL respectively. The FBG in the control group also increased from 238.33 mg/dL to 249.10 mg/dL during the study period. However, the DATES intervention increased the number of healthy weight patients from 42 to 55 (improvement of 10%) in the intervention group while the control group showed a worsening trend. With the 1 month DATES intervention, the number of normotensive patients increased from 21 to 32 while patients with BP greater than 120/75 mmHg decreased by 8% which was a statistically significant improvement compared to the control group. Physical activity scores also improved with sedentary life style in patients decreasing by 15% after intervention.
Although the fasting blood glucose levels did not improve after the intervention, the significant improvement in BMI, blood pressures and physical activity scores among the intervention group clearly suggests that if used for longer periods of time and if coupled with changes in medications and treatment regimens, intervention through mobile phone text messages can improve the glycemic control and overall quality of life in patients with type 2 diabetes.
How to Cite This Article
Altaf A, Bhatti AA, Gilanee AT, Asmar A. Diabetes and Telecommunications: Study to Support Self-Management for People with Type 2 Diabetes A Randomized Controlled Trial in Mayo Hospital, Lahore. J Pak Soc Intern Med. 2021;2(4):336–340. doi:10.70302/jpsim.v2i4.2177
Conflict of Interest
All authors declare no competing interests.
Funding
No specific funding was received for this research.
Funder information follows the Crossref Funder Registry standard.
References
- Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diab Care. 2004;27(5):1047-53.
- Tribunecompk. The Express Tribune. [Updated 2011, cited 2021]. Available from: [https://tribune.com.pk/story/162251/pakistan-has-seventh-highest-number-of-diabetics-in-the-world/]
- Rehman A, Khan JA, Abaidullah S, Zaheer J, SI MH. Characteristics of Diabetic Patients and Pattern of Diabetic Complications. Annals of KEMU. 2000;6(2):196-9.
- Lasker RD. The Diabetes Control and Complications Trial--Implications for Policy and Practice. N Engl J Med. 1993;329(1):1035-6
- Sicree R, Shaw J, Zimmet P. Diabetes Atlas, 2nd ed. International Diabetes Federation, Brussels; 2003.
- Rhee MK, Slocum W, Ziemer DC, Culler SD, Cook CB, El-Kebbi IM, et al. Patient adherence improves glycemic control. Diab Edu. 2005;31(2):240-50.
- Karter AJ, Parker MM, Moffet HH, Ahmed AT, Ferrara A, Liu JY, et al. Missed appointments and poor glycemic control: an opportunity to identify high-risk diabetic patients. Med Care. 2004;42 (2):110-5.
- Statistacom. Statista. [Updated November, 2016, cited 2021]. Available from: [https://www.statista.com/statistics/274774/forecast-of-mobile-phone-users-worldwide/]
- Ridge K, Treasure J, Forbes A, Thomas S, Ismail K. Themes elicited during motivational interviewing to improve glycaemic control in adults with Type 1 diabetes mellitus. Diab Med. 2012;29(1):148-52.
- Franklin VL, Waller A, Pagliari C, Greene SA. A randomized controlled trial of Sweet Talk, a text messaging system to support young people with diabetes. Diab Med. 2006;23(12):1332-8.
- Ramachandran A, Snehalatha C, Ram J, Selvam S, Simon M, NandithaA, et al. Effectiveness of mobile phone messaging in prevention of type 2 diabetes by lifestyle modification in men in India: a prospective, parallel-group, randomised controlled trial. Lancet Diab Endocrinol. 2013;1(3):191-8.
- US Department of Health and Human Services. National diabetes statistics report 2020: estimates of diabetes and its burden in the United States. Centers for Disease Control and Prevention. 2020.
- Nazar CM, Bojerenu MM, Safdar M, Marwat J. Effectiveness of diabetes education and awareness of diabetes mellitus in combating diabetes in the United Kigdom; a literature review. J Nephropharmacol. 2016;5(2):110-5.
- Bays HE, Chapman RH, Grandy S, SHIELD Investigators’ Group. The relationship of body mass index to diabetes mellitus, hypertension and dyslipidaemia: comparison of data from two national surveys. Int J Clin Prac. 2007;61(5):737-47.
- West DS, DiLillo V, Bursac Z, Gore SA, Greene PG. Motivational interviewing improves weight loss in women with type 2 diabetes. Diab Care. 2007;30(5):1081-7.
- Duan Y, Xie Z, Dong F, Wu Z, Lin Z, Sun N, et al. Effectiveness of home blood pressure telemonitoring: a systematic review and meta-analysis of randomised controlled studies. J Hum Hypertens. 2017;31(7):427-37
- Mui LW, Friedman RH, Lau JT, Peng J, Abdullah AS. A RCT to evaluate a totally automated, culturally-adapted telephone counselor for increasing physical activity among physically inactive individuals in China. BMC Public Health. 2018 ;18(1): 1-9
- Abbas BB, Al Fares A, Jabbari M, El Dali A, Al Orifi F. Effect of mobile phone short text messages on glycemic control in type 2 diabetes. Int J Endocrinol Metab. 2015;13(1):e18791.
- Dobson R, Whittaker R, Jiang Y, Maddison R, Shepherd M, McNamara C, et al. Effectiveness of text message based, diabetes self-management support programme (SMS4BG): two arm, parallel randomised controlled trial. bmj. 2018 ;361(8149):1959.
Reference list indexed for Google Scholar and ResearchGate. DOI links resolve via doi.org.