Text Messaging to Improve Uncontrolled A1c

Abstract

Abstract A diabetes clinic at a rural health department in western North Carolina, as at many clinics, has a large number of patients with an uncontrolled Hemoglobin A1c result. Hemoglobin A1c results that are consistently above 7.0% have been shown to be detrimental to health since it increases the risk of long-term complications. Many experts agree that lifestyle modification can positively affect the A1c. One non-pharmaceutical intervention that has shown promise to improve A1c is text messaging patients in-between visits. These text messages have been shown to reduce the A1c by up to 0.53%. The purpose of this project was to reduce Hemoglobin A1c levels in patients with uncontrolled A1cs of >7.0% by implementing a standardized text messaging program at a rural health department in western North Carolina. Health department diabetes clinic patients were enrolled in the text messaging program if they met the following criteria: willingness to participate by signing consent, a recent (within 3 months) A1c of > 7.0%, possession of a cell phone that can receive text messages, a diagnosis of Type 2 diabetes, and ability to complete a questionnaire. Participants were initially enrolled during a regular appointment at the health department diabetes clinic. At this visit, informed consent was obtained and the participants provided age, gender, recent A1c results with date, and cell phone number. Participants received two text messages per week for 3 months and one appointment reminder. These messages were standardized messages garnered from the National Diabetes Education Program with tips about diet, exercise, and medication adherence. At the end of 3 months, the A1c was then repeated in the clinic and participants completed a satisfaction questionnaire. Although the intervention did not reduce A1c to a statistically significant degree, 30% of participants experienced a reduction in A1c similar to that of an oral anti-diabetes medication. If expanded and applied to all patients with type two diabetes, this method could be an inexpensive addition to aid in the reduction of A1c.