Effectiveness of short message service-based intervention (SMS) on self-care in type 2 diabetes: A feasibility study

Prim Care Diabetes. 2016 Aug;10(4):251-8. doi: 10.1016/j.pcd.2015.11.001. Epub 2015 Dec 2.


Aim: The objective of the current study is to assess the effectiveness of Mobile Short Message Service (SMS) intervention on education of basic self-care skills in patients with type 2 diabetes. Moreover, we aimed to determine whether delivering individually-tailored educational messages can be more effective than general educational messages.

Methods: A total of 150 patients with diabetes type 2 were randomized into three groups: tailored SMS group, non-tailored SMS group, and the control group. Biochemical parameters including HbA1c, FBS, lipid profile were evaluated for the three groups at baseline and after 12 weeks. Moreover, self-care Inventory (SCI), Diabetes Management Self-Efficacy Scale (DMSES) and Diabetes Self-Care Barriers assessment scale for Older Adults (DSCB-OA) were completed. In the tailored SMS group, each person received 75% of their messages based on the top two barriers to adherence that they had experienced and reported in their scale. In the non-tailored SMS group, random messages were sent to every patient.

Results: After 12 weeks, although HgA1c levels did not significantly change, significant decline was observed in FBS and mean BMI in both intervention groups. Mean SCI-R scores significantly increased and mean DSCB and DMSES scores significantly decreased in both tailored and non-tailored SMS groups. In the control group, mean SCI-R scores decreased and mean DSCB and DMSES scores significantly increased (P<0.001).

Conclusion: Sending short text messages as a method of education in conjunction with conventional diabetes treatment can improve glycemic control and positively influence other aspects of diabetes self-care. According to our findings, sending SMS regularly in particular times appears to be as effective as sending individually tailored messages.

Keywords: Cellular phone; Diabetes type 2; Education; Self-care; Text messaging.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Biomarkers / blood
  • Blood Glucose / metabolism
  • Body Mass Index
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / diagnosis
  • Diabetes Mellitus, Type 2 / physiopathology
  • Diabetes Mellitus, Type 2 / therapy*
  • Fasting / blood
  • Feasibility Studies
  • Female
  • Glycated Hemoglobin / metabolism
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Iran
  • Male
  • Middle Aged
  • Patient Education as Topic*
  • Reminder Systems*
  • Self Care / methods*
  • Text Messaging*
  • Time Factors
  • Treatment Outcome
  • Triglycerides / blood
  • Weight Loss
  • Young Adult


  • Biomarkers
  • Blood Glucose
  • Glycated Hemoglobin A
  • Triglycerides
  • hemoglobin A1c protein, human