Comparing the effects of SMS-based education with group-based education and control group on diabetes management: a randomized educational program

Abstract

Background: The high prevalence of diabetes and the importance of long-term follow-up of these patients encourage finding an inexpensive and applicable educational method to control the disease. Distance education based on mobile technology and Short message service (SMS) can be an effective way to manage this disease by eliminating time and place limitations. Due to the world’s high penetration rate, SMS is one of the best ways to transfer information and health education. Objective: This study aimed to compare the effect of SMS- and group-based education in managing diabetes type 2 and compare them with a control group. Method: A total of 168 patients with diabetes type 2 under the coverage of three family physician clinics were randomly allocated into three groups. The education was conducted in 12 one-hour sessions once a week in the group-based arm, and a daily short message was sent to the participants in the SMS group. The control group also underwent routine care at the family physician clinic. The duration of the education was 3 months. At baseline and 3 months later, fasting blood sugar (FBS), 2 hours postprandial sugar (2hppBS), and HBA1c, as well as diabetes self-management questionnaire score (DSMQ), were measured. Results: The comparison of the three groups in terms of changes in FBS (P-value: 0.001), 2hppBS (8 P-value: < 0.001) and HbA1c (P-value: < 0.001) were significantly different after 3 months. In pairwise analysis, 2hppBS was the only significantly different parameter between the group- and SMS-based education (P-value: 0.035). Conclusion: Although the effect of both educational methods via SMS or group education was better than the control group in controlling diabetes, these two methods were not statistically different. Due to spending a lot of time and money on group-based education, it is better to replace it with education by SMS.