Text‐message responsiveness to blood glucose monitoring reminders is associated with HbA1c benefit in teenagers with Type 1 diabetes
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Aims: To evaluate an 18‐month text‐messaging intervention in teenagers with Type 1 diabetes and to assess factors associated with text responsiveness and glycaemic benefit. Methods: Teenagers with diabetes (N = 147), aged 13–17 years, received two‐way text reminders at self‐selected times to check blood glucose levels and reply with blood glucose results. Results: At baseline, the participants (48% boys, 78% white, 63% pump‐treated) had a mean ± sd age of 14.9 ± 1.3 years, diabetes duration of 7.1 ± 3.9 years and HbA 1c concentration of 69 ± 12 mmol/mol (8.5 ± 1.1%). The mean proportion of days with ≥1 blood glucose response declined over time (0–6 months, 60 ± 26% of days, 7–12 months, 53 ± 31% of days, 13–18 months, 43 ± 33% of days). Over 18 months, 49% responded with ≥1 blood glucose result on ≥50% of days (high responders). Regression analysis controlling for baseline HbA 1c revealed no significant change in HbA 1c from baseline to 18 months in high responders (P = 0.54) compared with a significant HbA 1c increase in low responders (+0.3%, P = 0.01). In participants with baseline HbA 1c ≥64 mmol/mol (≥8%), high responders were 2.5 times more likely than low responders to have a clinically significant [≥5.5 mmol/mol (≥0.5%)] HbA 1c decrease over 18 months (P < 0.05). In participants with baseline HbA 1c <64 mmol/mol(<8%), high responders were 5.7 times more likely than low responders to have an 18‐month HbA 1c <58 mmol/mol (<7.5%; P < 0.05). Conclusions: Teenagers with Type 1 diabetes who responded to text reminders on ≥50% of days over 18 months experienced clinically significant glycaemic benefit. There remains a need to tailor interventions to maintain teenager engagement and optimize improvements.
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Text messaging approaches tied to lifestyle and treatment programs vary in effectiveness.
“There are text messaging approaches that tie into a variety of different types of lifestyle and treatment programs, which vary in terms of their effectiveness (272,273).”
From 7. Diabetes Technology: Standards of Care in Diabetes—2025 (2025) · cites this paper as [272]
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- Authors
- McGill, D. E., Volkening, L. K., Butler, D. A., Wasserman, R. M., Anderson, B. J., & Laffel, L. M.
- Affiliations
- Joslin Diabetes Center (US)
- Baylor College of Medicine (US)
- Corresponding author
- Laffel, L. M.
- Venue
- Diabetic Medicine
- Publisher
- Wiley
- Published
- 2019-02-25
- Volume
- 36
- Issue
- 5
- Pages
- 600-605
- ISSN
- 0742-3071 (ISSN-L)
- 1464-5491
- PMC
- PMC6462241
- OpenAlex
- W2914243347
- Cited by
- 27
- References
- 20
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 4 · 2023: 4 · 2022: 1 · 2021: 7 · 2020: 4 · 2019: 3
- FWCI
- 5.11
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Diabetic Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Juvenile Diabetes Research Foundation International (2‐SRA‐2014‐253‐M‐B)
- National Institutes of Health (K12DK094721, P30DK036836, R01DK095273)
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- type 1 diabetes, adolescents, text messaging, mobile health, blood glucose monitoring, HbA1c, glycemic control, patient engagement, diabetes self-management
- MeSH terms
- Adolescent, Adolescent Behavior, Attitude to Health, Blood Glucose, Diabetes Mellitus, Type 1, Female, Glycated Hemoglobin, Humans, Male, Patient Participation, Blood Glucose Self-Monitoring, Reminder Systems, Text Messaging
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