Short Message Service as a Tool for Health Education in Families of Children with Type 1 Diabetes in Pakistan: A Randomized Control Trial

Abstract

Objective: To determine the efficacy of short message service (SMS) for educating families of children with Type 1 Diabetes (T1D). Study Design: Single-masked randomized control trial (IRCT: 54713). Place and Duration of Study: Tertiary care hospitals of Rawalpindi and Islamabad Pakistan, from Mar to Jul 2021. Methodology: Twenty-nine T1D patients aged 1 to 18 years were randomly allotted to two groups: 15 to intervention or Group-A (receiving 5 SMS per week) and 14 to Control or Group-B (receiving disease education during hospital visits). Patients were followed up and their blood sugar levels (BSLs), HbA1c levels, journal maintenance, number of ER visits, number of Self-Monitored Blood Glucose (SMBG) levels, and hypoglycemic episodes compared at baseline and after intervention. Results: HbA1c had a mean decrease of 2.13±1.89% in Group-A and a mean increase of 0.18±0.84% in Group-B (p-value <0.001). Similarly, the decrease in BSLs post-intervention was significantly greater in Group-A (p-value=0.001). Trends in secondary outcomes: journal maintenance, number of self-monitoring blood glucose levels, admissions in ER, and hypoglycemic episodes in the past three months showed improving trends in both groups. However, the p-value was significant postintervention only for hypoglycemia incidence (p-value=0.021) and diary maintenance (p-value=0.005). Conclusion: SMS is an efficient tool for delivering education to T1D patients that significantly improves metabolic control. In light of these results, current routine practice is not sufficient to achieve therapeutic goals

Keywords

• blood sugar levels (BSLs)
• education
• HbA1c
• SMS
• type1 diabetes
• telemedicine