In October 2016, the Scripps Whittier Diabetes Institute was awarded $2.9 million by the National Institutes of Health (NIH) to study the effect of text messages in managing diabetes.
Today, we cannot deny the increasing numbers of diabetes cases in the world. The increase has got the United Nations worried since their target of achieving a plateau in numbers by 2025 appears to be threatened by this rapid increase in cases.
Treating diabetes alone does not contain the disease. There are many warning signs that are ignored in normal people or even those who have the initial stages of diabetes. For example, diabetes can result in the development of eye disease. Diabetics who do not get annual eye exams may eventually suffer from blindness.
In 2014, the Scripps Whittier Diabetes Institute conducted a study in 126 Hispanic diabetic adults called Dulce (please note the irony in the word; dulce a.k.a sweet!) Digital Study. (Hispanics have twice the chance of procuring diabetes compared with whites.)
The Hispanic diabetic adults were observed for 6 months to see the effect of text messages as a means of managing diabetes. The Hispanic adults were of a lower economic background and were found to lack access to proper medical attention.
The adults were mostly female (74%) with an average age of 49 years. The annual income was less than $24 000. The study group contained 53 adults that received text messages at a frequency of 2 to 3 each day. Text messages were encouraging messages (Eat in a small plate so you feel you are eating larger portions and will feel satisfied) or reminders (Make sure you take your medications on time each day).
The frequency of the text messages reduced over the period of 6 months. These adults displayed a decrease in the blood sugar (HbA1c) levels from 9.4% to 8.4%. The control group showed a minimal decrease in their HbA1c levels from 9.5% to 9.4%.
“The study appeared to indicate that regular text messages could help in managing diabetes.”
Now, the NIH has decided to provide funding for this study to see if this is a viable option in those from the Hispanic community who come from a poor socioeconomic background. The National Alliance for Hispanic Health predicts that nearly 55% of Hispanic adults may develop diabetes in their life.
The Dulce Digital-Me program differs from the Dulce Digital program in that the text messages that are sent to the participants are more personalized based on the real-time health situation of the patient. The study is going to look at the effect of the quality of communication between the patient and the nurse or doctor between the 2 groups. Do standardized messages have the same effect on the communication aspect, adherence to medication, and dietary control? Or do personalized messages have a more influential role in the above categories?
Four hundred and fourteen Hispanic type 2 diabetic adults will be monitored in this study with half being sent personalized text messages and the other half will be sent standard text messages. The cholesterol levels, HbA1c levels, and blood pressure levels will be measured.
By conducting this survey and analysis, the type of involvement in diabetes control in the Hispanic community will improve. The burden on the country’s healthcare finances will be subsequently reduced.
It is estimated that the number of mobile phone users will rise to 5 billion by 2020. Hence, harnessing the full scope of mobile phones in the area of health will be beneficial. It is a cost-effective means of communication. Text messaging is simple, direct with the patient and has been implemented in healthcare and specially diabetes in India as well.
The Dulce Digital-Me program evolved from the original Dulce Digital Study because the patients requested for more personalized messages. Clinicians suggested that messages based on the health behavior of the patient would benefit diabetes management.
The success of this study will chart out a new and highly technologically involved management of diabetes. It will also be an all inclusive approach to target and create awareness of the disease in individuals.
This is going to be a collaborative project between Scripps, San Diego State University Department of Psychology, and University of California, San Diego Department of Family Medicine and Public Health.
