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A randomized controlled trial of Sweet Talk

A randomized controlled trial of Sweet Talk: a text-messaging system to support young people with diabetes

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Original languageEnglish
Pages (from-to)1332-1338
Number of pages7
JournalDiabetic Medicine
Issue number12
StatePublished - 1 Dec 2006


Aims   To assess Sweet Talk, a text-messaging support system designed to enhance self-efficacy, facilitate uptake of intensive insulin therapy and improve
glycaemic control in paediatric patients with Type 1 diabetes.
Methods   One hundred and twenty-six patients fulfilled the eligibility criteria;
Type 1 diabetes for > 1 year, on conventional insulin therapy, aged 8–18 years.
Ninety-two patients were randomized to conventional insulin therapy (n = 28),
conventional therapy and Sweet Talk (n = 33) or intensive insulin therapy and Sweet Talk (n = 31). Goal-setting at clinic visits was reinforced by daily
text-messages from the Sweet Talk software system, containing personalized
goal-specific prompts and messages tailored to patients’ age, sex and insulin
Results   HbA1c did not change in patients on conventional therapy without or
with Sweet Talk (10.3±1.7 vs. 10.1±1.7%), but improved in patients randomized
to intensive therapy and Sweet Talk (9.2±2.2%, 95% CI -1.9, -0.5, P < 0.001). Sweet Talk was associated with improvement in diabetes self-efficacy
(conventional therapy 56.0±13.7, conventional therapy plus Sweet Talk 62.1±
6.6, 95% CI +2.6, +7.5, P = 0.003) and self-reported adherence (conventional
therapy 70.4±20.0, conventional therapy plus Sweet Talk 77.2±16.1, 95% CI
+0.4, +17.4, P = 0.042). When surveyed, 82% of patients felt that Sweet Talk
had improved their diabetes self-management and 90% wanted to continue
receiving messages.
Sweet Talk was associated with improved self-efficacy and adherence; engaging a classically difficult to reach group of young people. While Sweet Talk alone did not improve glycaemic control, it may have had a role in supporting the introduction of intensive insulin therapy. Scheduled, tailored text messaging offers an innovative means of supporting adolescents with diabetes and could be adapted for other health-care settings and chronic diseases.



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