"Sweet Talk": Text Messaging Support for Intensive Insulin Therapy for Young People with Diabetes

TLDR

Effective diabetes management requires substantial behavioural change, yet nonadherence remains a major cause of poor glycaemia, and while psychological interventions are costly and often unappealing to adolescents, text messaging is a widely used, personal, and transportable medium that could bridge the gap between clinic visits and intensive insulin therapy. The study aims to develop a text‑messaging system that combines behavioural health strategies with individualized messages to increase adherence to intensive insulin regimens and improve clinical outcomes between clinic visits. Sweet Talk delivers tailored diabetes information and motivation messages grounded in social cognition theory, the health belief model, and goal‑setting principles, providing continuous support between visits to promote adherence.

Abstract

Optimal diabetes management involves considerable behavioural modification, while nonadherence contributes significantly to poor glycaemia. Extensive research on psychological interventions aiming to improve glycaemia suggests that current strategies are costly and time-consuming and in our experience do not appeal to young people with Type 1 diabetes. Text messaging has rapidly become a socially popular form of communication. It is personal, highly transportable, and widely used, particularly in the adolescent population. However, text messaging coupled with specific behavioural health strategies has yet to be utilised effectively. We have developed a novel support network ("Sweet Talk"), based on a unique text-messaging system designed to deliver individually targeted messages and general diabetes information. Individualised motivation strategies—based on social cognition theory, the health belief model, and goal setting—form the theoretical basis of the message content. Intensifying insulin therapy and increasing contact with the diabetes team can improve control, but are difficult to provide within existing resources. Our support system offers a means of contact and support between clinic visits and aims to increase adherence with intensive insulin regimens and to improve clinical outcome.