A pragmatic and scalable strategy using mobile technology to promote sustained lifestyle changes to prevent type 2 diabetes in India and the UK: a randomised controlled trial.
Godsland, Ian F
Johnston, Desmond G
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Nanditha, A., Thomson, H., Susairaj, P., Srivanichakorn, W., Oliver, N., Godsland, I. F., Majeed, A., et al. (2020). A pragmatic and scalable strategy using mobile technology to promote sustained lifestyle changes to prevent type 2 diabetes in India and the UK: a randomised controlled trial.. Diabetologia, 63 (3), 486-496. https://doi.org/10.1007/s00125-019-05061-y
Abstract Aims/hypothesis This randomised controlled trial was performed in India and UK in people with prediabetes to study whether mobile phone short message services can be used to motivate and educate people to follow lifestyle modification, to prevent type 2 diabetes. Methods The study was performed in people with prediabetes (n=2062, control: n=1031; intervention: n=1031) identified by glycosylated haemoglobin A1c42 and 47mmol/mol (6.0% and 6.4%). Participants were recruited from public and private sector organisations in India and by the NHS Health Checks programme in the UK. Allocation to the study groups was performed using a computer generated sequence (1:1) in India and by stratified randomisation in permuted blocks in the UK. Investigators in both countries remained blinded throughout the study period. All participants received advice on healthy lifestyle at baseline. The intervention group in addition received supportive text messages using mobile phone short messaging services2-3 times per week. Participants were assessed at intervals for 2years. The primary outcome was conversion to diabetes and secondary outcomes included anthropometry, biochemistry, dietary and physical activity change, blood pressure and quality of life. Results At 2years follow-up, in the intention-to-treat population the hazard ratio for development of diabetes calculated using a discrete-time proportional hazards model was 0.89,95%CI(0.74-1.07) p=0.22. There were no significant differences in the secondary outcomes. Conclusions/Interpretation This trial in 2 countries with varied ethnic and cultural backgrounds showed no significant reduction in the progression in diabetes in 2 years by lifestyle modification using short messaging services (Hazard Ratio 0.89, 95% CI 0.74 – 1.07, p=0.22) Trial Registration The primary study was registered on www.ClinicalTrials.gov; India (NCT01570946), UK (NCT01795833). The study was funded jointly by the Indian Council for Medical Research and the UK Medical Research Council
Humans, Diabetes Mellitus, Type 2, Prediabetic State, Hyperglycemia, Blood Glucose, Monitoring, Physiologic, Sample Size, Program Evaluation, Risk Reduction Behavior, Life Style, Preventive Medicine, Telemedicine, Adult, Aged, Middle Aged, India, Female, Male, Text Messaging, United Kingdom, Glycated Hemoglobin A, Cell Phone
Funding was obtained jointly from the Indian Council for Medical Research (Ref. No. 58/1/6/ICMR-MRC/2009-NCD-II) and the UK Medical Research Council (Joint funding ref: MR/J000183/1). NJW, SJS, SB and KW are supported by the Medical Research Council (MC_UU_12015/1 and MC_UU_12015/3).
Department of Health (via National Institute for Health Research (NIHR)) (NF-SI-0617-10149)
IMPERIAL COLLEGE OF SCIENCE TECHNOLOGY & MEDICINE (FB MRC) (MR/J000183/1)
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External DOI: https://doi.org/10.1007/s00125-019-05061-y
This record's URL: https://www.repository.cam.ac.uk/handle/1810/298711
Attribution 4.0 International
Licence URL: https://creativecommons.org/licenses/by/4.0/