Texting System Helps Teens With Diabetes Improve Glycemic Control

Two-way text messaging system either maintained or improved A1C levels for teens with type 1 diabetes.

A 2-way text messaging system either maintained or improved A1C levels for teens with type 1 diabetes (T1D), presented today at the American Diabetes Association’s 77th Scientific Sessions in San Diego.

In a year-long trial, researchers from the Joslin Diabetes Center randomly assigned 301 teenagers to eitehr a text messaging system, which reminded the teens to check blood glucose, a problem-solving intervention, both of those interventions, or standard care.

At the beginning of the study, the participants had an overall average A1C of 8.5%. Insulin pumps were used by 63% of the sample, and all patients were seen by their health providers quarterly.

The research indicated that text message reminders appeared to preserve and potentially improve glycemic control. Additionally, in a multivariate mixed linear model, the frequency of response to text messages significantly predicted A1C levels (P < .003), while the problem solving intervention did not. During the 12-month period, the teens who responded to the majority of the text message reminders — those with a response rate of 68 to 100% —demonstrated the best glycemic control, with A1C levels an average of 8.1%. Further, the A1C benefit resulting from teens responding to the majority of text reminders was similar for teens in both the TM and TM+PS groups.

“It is important to recognize the challenges faced by teens with type 1 diabetes as they navigate increasing independence in self-care,” lead study author Lori Laffel, MD, MPH, chief of the Pediatric, Adolescent and Young Adult Section and senior investigator/co-head of the Section on Clinical, Behavioral and Outcomes Research at Joslin Diabetes Center; and professor of pediatrics at Harvard Medical School said in a press release about the findings. “Given the current landscape of cellphone use among teens, it is fitting to evaluate the potential impact of text message reminders aimed at assisting teens and young adults with their diabetes self-management as they transition from pediatric to adult diabetes care.”


Laffel L, et al. Text Message Intervention for Teens with Type 1 Diabetes (T1D) Preserves A1C: Results of an RCT. Presented at: The American Diabetes Association’s 77th Scientific Sessions, June 9-13, 2017. San Diego.