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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

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Title: 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
Authors: Oliver, N
Johnston, D
Godsland, I
Srivanichakorn, W
Majeed, A
Darzi, A
Item Type: Journal Article
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 A1c42 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)
Issue Date: 9-Jan-2020
Date of Acceptance: 1-Nov-2019
URI: http://hdl.handle.net/10044/1/74855
DOI: 10.1007/s00125-019-05061-y
ISSN: 0012-186X
Publisher: Springer Verlag
Start Page: 486
End Page: 496
Journal / Book Title: Diabetologia
Volume: 63
Copyright Statement: © The Author(s) 2020. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Sponsor/Funder: Medical Research Council (MRC)
National Institute of Health Research
Funder's Grant Number: MR/J000183/1
Keywords: Science & Technology
Life Sciences & Biomedicine
Endocrinology & Metabolism
Behavioural change
Diabetes prevention
Glycosylated haemoglobin A(1c)
Lifestyle modification
Mobile technology
Prediabetes
Screening
Short message service
BEHAVIOR-CHANGE
RISK-FACTOR
INTERVENTIONS
DISEASE
SUPPORT
WEIGHT
Behavioural change
Diabetes prevention
Glycosylated haemoglobin A1c
Lifestyle modification
Mobile technology
Prediabetes
Screening
Short message service
Endocrinology & Metabolism
1103 Clinical Sciences
1114 Paediatrics and Reproductive Medicine
1117 Public Health and Health Services
Publication Status: Published
Online Publication Date: 2020-01-09
Appears in Collections:Department of Surgery and Cancer
Institute of Global Health Innovation