JMIR Publications

ABSTRACT

Background:

Type 2 diabetes mellitus (T2DM) is an international problem of alarming epidemic proportions. Reasons to develop T2DM can be multifactorial and usually begins with prediabetes. Prediabetes is an asymptomatic phase when blood glucose levels (BGL) are higher than normal but not high enough to be diagnosed with T2DM and/or characterized by insulin resistance. Fortunately, this disease can be prevented by following a healthy lifestyle. However, many healthcare systems fail to properly educate the public on disease prevention and to offer support in embracing behavioral interventions to prevent diabetes. To our knowledge, use of nationwide SMS messaging in the Middle East as a screening tool to identify individuals who might be at risk of developing T2DM has not been presented in the literature. The impact of circulating short text messages in a form of health campaigns to reach those who may have prediabetes, asymptomatic diabetes, or who are at high risk for diabetes is unknown.

Objective:

To evaluate the feasibility of text-message screening (TMS) using short message service (SMS) campaigns to detect people who might be at risk of developing type 2 diabetes mellitus (T2DM) in Kuwait.

Methods:

Five separate TMS campaigns were launched inviting recipients to answer 6 questions to determine risk of developing T2DM. If subjects agreed to participate, a link to the CDC prediabetes screening test was automatically transmitted to their mobile devices. Those identified as high risk were invited to participate in a diabetes prevention program.

Results:

A total of 180,000 SMSs were sent to 6% of the adult population in Kuwait. Of these, 260 (0.14%) individuals agreed to participate and of these 153 (58.8%) completed the screening. Surprisingly, additional surveys were completed by 367 individuals who were invited based on circulated SMS messages forwarded by family members and friends. Altogether, 121 qualified and agreed to participate in a diabetes prevention program. Of those who chose to participate in the prevention program, more were overweight, tended to be in the 45 to 65 age bracket, and reported being less physically active than those who chose not to participate (p<0.05).

Conclusions:

Text messaging healthcare screening was found to have limited effectiveness alone but had increased reach through shared second-party social media messaging. Although a subpopulation who might be at risk of developing T2DM could be reached using text messaging, most responders were informed about the screening campaign by family and friends. Future research designed to tap into the benefits of social media in health risk campaigns is encouraged.