Lifestyle intervention through regular text messaging seems to have a long-term impact on lowering the risk of diabetes, according a post-trial analysis carried out by a group of scientists. Scientists at the Dr. A. Ramachandran’s Diabetes Hospitals in Chennai conducted a post-trial analysis of the Indian SMS diabetes prevention study.

Effective tool

The primary trial (2010-12) had showed that mobile phone-based text messaging was an effective tool to deliver lifestyle changes among participants, with a 36% relative risk reduction in the incidence of diabetes. The post-trial analysis taken up in 2016 found that this prevention strategy of sending text messages had beneficial effects that persisted up to five years — three years after the text messages were stopped. At the end of five years, the cumulative incidence of type 2 diabetes continued to be lower among participants who received text messages than those in the control group during the primary trial. This was published recently.

The primary two-year randomised trial compared lifestyle changes through the use of text messaging reminders in the intervention group of 271 participants versus standard care advice for 266 in the control group.

At the end of the active phase, 517 of the 537 men were available for review. Among them, 73 out of the 266 in the control group and 60 of 271 in the intervention group developed diabetes. Both groups were advised on lifestyle modification. Next, the doctors wanted to find out how the SMS strategy worked.

Post-trial follow-up

“We decided to do a post-trial follow-up. Three years after the primary trial, we wanted to see if there was a continued change in their lifestyle habits, and continued reduction in diabetes, and long-lasting effect of intervention,” said A. Ramachandran, president of India Diabetes Research Foundation.

The post-trial data was collected from February to May 2016.

A total of 394 participants free of diabetes were invited to ascertain the sustained effect. Among them, 346 (163 control group and 183 intervention group) were available for fifth year assessment. The incidence of diabetes in the three-year post-trial period was 29 out of 183 in the intervention group, against 33 out of the 163 in the control group.

The cumulative incidence for five years was 106 out of 236 responders for control group and 79 out of 233 for intervention group.

“The impact continued. There was still 30% relative risk reduction in the incidence of diabetes at the end of five years. The study, using mobile technology, motivated people for lifestyle changes and its effect was quite robust,” he said.

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