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mHealth Intervention to Prevent Type 2 Diabetes Mellitus (Phase II Study)

Not Applicable
Completed
Conditions
Prediabetic State
Interventions
Behavioral: preDIABE-TEXT
Other: Online Education
Registration Number
NCT05110625
Lead Sponsor
Fundació d'investigació Sanitària de les Illes Balears
Brief Summary

The aim of this study is to develop and evaluate a low intensity, multifaceted, digital health intervention to prevent T2DM based on: i) the use of a system comprising mobile health (mHealth) technology integrated with electronic health records to send tailored text messages (SMSs) promoting lifestyle changes in people at risk of T2DM, and, ii) the provision of online education to primary healthcare workers about prediabetes management.

Detailed Description

The PREDIABETEXT project will involve five WorkPackages (WP). In WP1-4 we will develop and pilot-test the different components of the intervention (WP1 will develop the brief text messages targeted to patients; WP2 will adapt our existing technology system to deliver the messages; WP3 will develop an educational intervention targeted to Primary Healthcare workers, and; WP4 will pilot-test and optimise both interventions). In WP5 we will conduct a phase II, six-month, three-arm, cluster randomised, clinical trial with 42 primary care workers and 420 patients at risk of T2DM (HbA1c from 6% to 6.4% or fasting plasma glucose 110-125mg/dl, or both) registered in Primary Care centres from Mallorca. Patients will be allocated to a control (usual care) group, intervention A (patient messaging intervention), or intervention B (patient messaging intervention plus online education to their primary healthcare workers). The primary outcome will be HbA1c. Secondary outcomes will include additional clinical outcomes, and physiological, behavioural and psychological outcomes.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
365
Inclusion Criteria
  • Registered in the Public Health Service of the Balearic Islands
  • At risk of T2DM (HbA1c from 6% to 6.4% within the last 3 months or two consecutive values of fasting plasma glucose 110-125mg/dl within the last 12 months, or both)
  • With access to a mobile device able to receive text messages.
Exclusion Criteria
  • People not able to read messages in Spanish
  • Patients with severe mental conditions.
  • Patients on an antidiabetic medication regime
  • Pregnancy: currently or during the previous 12 months
  • People planning to change healthcare centre during the intervention period

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Intervention BpreDIABE-TEXTParticipants will receive messaging intervention plus online education to their primary healthcare workers
Intervention BOnline EducationParticipants will receive messaging intervention plus online education to their primary healthcare workers
Intervention ApreDIABE-TEXTParticipants will receive Messaging Intervention
Primary Outcome Measures
NameTimeMethod
Change from Baseline Glycated Hemoglobin (HbA1C) at 6 monthsBaseline and Postintervention (6 months)
Secondary Outcome Measures
NameTimeMethod
Change from Baseline high density cholesterol (HDL) at 6 monthsBaseline and Postintervention (6 months)
Change from Baseline Triglycerides at 6 monthsBaseline and Postintervention (6 months)
Change from Baseline Total Cholesterol at 6 monthsBaseline and Postintervention (6 months)
Change from Baseline Fasting blood glucose at 6 monthsBaseline and Postintervention (6 months)
Change from Baseline lipoprotein A at 6 monthsBaseline and Postintervention (6 months)
Change from Baseline aspartate aminotransferase enzyme (AST) at 6 monthsBaseline and Postintervention (6 months)
Change from Baseline alanine aminotransferase (ALT) at 6 monthsBaseline and Postintervention (6 months)
Change from Baseline Waist Circumference at 6 monthsBaseline and Postintervention (6 months)
Change from Baseline of Cardiovascular disease risk at 6 monthsBaseline and Postintervention (6 months)

Cardiovascular disease risk determined using the REGICOR calculator (www.imim.cat; Ramos et al., 2003)

Change from Baseline low density cholesterol (LDL) at 6 monthsBaseline and Postintervention (6 months)
Change from Baseline urinary sediment at 6 monthsBaseline and Postintervention (6 months)
Change from Baseline Blood Pressure at 6 monthsBaseline and Postintervention (6 months)
Quantification of alcohol consumption - FISTERRABaseline and Postintervention (6 months)

Calcultaion of alcohol consumption in Spanish Standard Drink units (10g per unit) per week.

https://www.fisterra.com/herramientas/calcumed/

Change from Baseline complete hemogram at 6 monthsBaseline and Postintervention (6 months)
Change from Baseline albumin-craetinine ratio at 6 monthsBaseline and Postintervention (6 months)
Change from Baseline Body Weight at 6 monthsBaseline and Postintervention (6 months)
Diagnosis of T2DMPostintervention (6 months)
REGICOR Short form Physical Activity QuestionnaireBaseline and Postintervention (6 months)

The questionnaire is a reliable and valid method to estimate moderate and vigorous intensity leisure time physical activity and sensitive to detect changes in moderate and vigorous intensity leisure time physical activity https://regicor.cat/aplicacions/activitat-fisica/

Change from Baseline gamma glutamil transpeptidase (GGT) at 6 monthsBaseline and Postintervention (6 months)
Change from Baseline creatinine at 6 monthsBaseline and Postintervention (6 months)
Change from Baseline serum albumin at 6 monthsBaseline and Postintervention (6 months)
Brief motivation questionnaire (ad hoc)Baseline and Postintervention (6 months)

On a scale from 0 to 7, this questionnaire meassures the level of motivation that participants present for following a healthy diet and a physical activity plan.

Change from Baseline insuline at 6 monthsBaseline and Postintervention (6 months)
14-point Mediterranean diet adherence screener (MEDAS-14)Baseline and Postintervention (6 months)

Adherence to healthy diet. The score ranges from 0 to 14. A higher score corresponds to a higher adherence to Mediterranean diet. We will classify participants as low adherents (≤5), moderate adherents (6-9) or high adherents (≥10).

Spanish version of the physical activity questionnaire used in the Physical activity questionnaire from the Nurses' Health StudyBaseline and Postintervention (6 months)

We will use the second part of the questionnaire, which studies sedentary behaviour. It includes questions about the number of hours spent in sedentary activities.

Public Health Nutrition: 8(7), 920-927 https://nurseshealthstudy.org/

Global Adult Tobbacco Survey: GATS questionnaire.Baseline and Postintervention (6 months)

Tobbacco consumption. 3-items adapted from the GATS questionnaire (WHO).

Trial Locations

Locations (1)

Ignacio Ricci-Cabello

🇪🇸

Palma De Mallorca, Balearic Islands, Spain

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