Crossing the digital divide with diabetes text messages:

‘Old school’ text messaging is at the heart of an mHealth project to help motivate and support people with poorly controlled diabetes.

Results from the pilot study indicate that keeping the technology simple and focusing on motivational text messages still made a positive difference to people’s blood glucose control.

Public health physician and mHealth innovator Dr Robyn Whittaker says the research team chose texting as it was conscious that a digital divide still exists, as not everybody has access to the internet by a broadband connection or a smartphone. Also internet and smartphone connectivity is still an issue in parts of the country and the affordability of mobile data is another issue.

“But everybody has access to a mobile phone and any phone can receive a text message – even if the phone is not in credit.”

Whittaker, who is the public health physician for innovation and research at Waitemata District Health Board and an associate professor at The University of Auckland’s National Institute for Health Innovation, says following a successful pilot of the joint DHB and university project, it is now running a larger randomised controlled trial across the country.

The SMS4BG (self-management support for blood glucose) programme offers people with diabetes (type 1 and type 2) a package of modules (including Māori and Pacific versions). Some participants choose to just receive motivational texts to help them manage their diabetes. But others also receive regular reminders to check their blood glucose – and can opt to send their blood glucose levels to the research team to be graphed – plus a range of other modules covering smoking cessation to preventative behaviour modules

The pilot with 42 participants saw some “really good improvement in glucose control” leading to the larger trial. The trial is seeking 1,000 participants – half randomised to receive the SMSB4G programme for up to nine months in addition to usual diabetes care and the other half receiving just usual diabetes care – and is still enrolling participants with a lot of referrals coming through primary health and diabetes nurses.

To find out more about the SMS4BG study – or enroll a patient – email


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