Text messaging interventions are associated with reductions in hemoglobin A1c (HbA1c) among patients with diabetes: a systematic review and meta-analysis
Pooled result · HbA1c change from baselineResult — go to the resultGreater reduction in percent HbA1c 0.29 % HbA1c 95% CI 0.14–0.45Authors' conclusion
Text messaging interventions are associated with modest improvements in glycemic control over 3-6 months, particularly in patients with poorer baseline HbA1c. These effects may be meaningful at scale and support texting as a potential adjunct to routine diabetes care. Benefits appear to diminish by 12 months, underscoring the need for high-quality trials focused on long-term impact and intervention optimization.
Study context
- Population
- Adults with diabetes in high-income countries
- Comparison
- Texting interventions vs standard care
- Outcome
- Between-group difference in HbA1c change from baseline
Methodological detailsinverse variance random-effects model, high-income countries, Risk of bias and quality of evidence assessed with Cochrane and GRADE tools; heterogeneity by I2
- Inverse variance random-effects model
- High-income countries
- Risk of bias and quality of evidence assessed with Cochrane and GRADE tools; heterogeneity by I2
Pooled result
HbA1c change from baseline · 3 months
Greater reduction in percent HbA1c
0.29 % HbA1c
95% CI 0.14–0.45
P = 0.0001
As reported in the abstract
Further pooled results
| Outcome | Estimate | P value |
|---|---|---|
| HbA1c change from baseline · 6 months | greater HbA1c reduction 0.19 (95% CI 0.07–0.30) | P = 0.001 |
| HbA1c change, studies with mean baseline HbA1c ≥8.6% · 3 monthsGreater reduction with texting | greater HbA1c reduction 0.48 | P = 0.004 |
| HbA1c change, studies with mean baseline HbA1c ≥8.6% · 6 monthsGreater reduction with texting | greater HbA1c reduction 0.36 | P = 0.004 |
- HbA1c change from baseline: greater reduction with texting; I2=45%; 20 trials, n=2,332 intervention, n=2,371 control
HbA1c change from baseline · 12 months
- Non-significant benefit associated with texting (seven trials, n=2,038)
HbA1c change, studies with mean baseline HbA1c ≥8.6% · 6 months
- Subgroups were not significantly different
Original publication
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