Introduction
Interventions involving text messaging have been shown to improve risk factors and HbA1c in people with diabetes. We conducted a pilot randomised controlled trial to determine if a structured program of text messaging interacting with an activity monitor, for women after gestational diabetes (GDM), improves healthy behaviours.
Methods
Women with GDM were recruited and randomised (2:1) to Intervention or Control. The Intervention comprised a 6 month structured program of 4 text messages a week promoting healthy behaviour in conjunction with an activity monitor (Fitbit®). Feedback from the activity monitor tailored the text messages to support gradually attainment of 10,000 steps per day. Attendance for a glucose tolerance test (GTT) by 12 weeks, and weight, diet, and physical activity (PA) at 10 weeks (baseline) and 36 weeks post-partum were assessed.
Results
60 women were recruited with 40 randomised to intervention and 20 to control. There was no difference between the groups in the completion of the GTT by 12 weeks (Intervention 28/40 vs Control 13/20). There was a high drop-out rate and only 30 women completed all elements of the 36 week final evaluation. There was no difference in the achievement of 150 minutes moderate intensity PA a week (7/20 vs 3/10, p=1.0), weekly step count (46258±29189 vs 39658±16369, p=0.40), dietary fat intake ≤30% of energy (4/23 vs 4/11, p=0.39) and weight loss (-1.7±4.1 vs -1.1±3.3 kgs, p=0.47) at 6 months. There was a difference in total energy intake (7760±2878 vs 8322±1726 kj, p=0.045), and a trend to higher total weekly activity time (190±306 vs 127±128 minutes, p=0.17).
Conclusion
Our pilot study demonstrates proof of concept that linking activity monitors to healthy text messages is feasible, but in this population, maintaining participation is challenging. The modest number of subjects completing the study limited statistical power but the trend to improvement in some outcomes suggests that a larger study is worth conducting.