Effectiveness of Text Messaging Intervention to Improve Dietary Behaviors Among Patients with Type 2 Diabetes Mellitus in Low Resource Area of Sabah (DTEXT-SBH)

Not Applicable

Not yet recruiting

Brief Summary: The goal of this clinical trial is to learn if sending three (3) text messages per week over a six (6) months period to people with Type 2 Diabetes in areas with lack access to dietitian could help them stick to a healthier diet. The main questions it aims to answer are:

* Does a mobile phone text-message intervention improve dietary adherence among T2DM patients?

* Does a mobile phone text-message intervention improve HbA1c and self-management among T2DM patients? Researchers will compare dietary adherence, HbA1c changes and self-management behaviors between the usual care group and intervention group.

Participants will:

* Be given three (3) text messages per week over a six (6) months period for the intervention group

* Both usual care and intervention group will be given standard medical nutrition therapy at baseline, 3rd and 6th months visits to the clinic

Recruitment & Eligibility

Inclusion Criteria

Exclusion Criteria

individuals with type 1 diabetes mellitus and gestational diabetes mellitus.
patients with cognitive impairment affecting memory, attention, language, and problem-solving skills.
those with advanced diabetic complications, such as kidney failure and neuropathy.
individuals lacking regular access to a mobile phone or with poor network connectivity.
pregnant individuals or those planning to get pregnant in the next 6 months, as well as those currently nursing.
individuals with major illnesses like cancer or advanced heart disease.
those planning major surgery or gastric bypass in the next 6 months.
institutionalized individuals, such as those in nursing homes, old folks' homes, or imprisoned.

Arm && Interventions

Group	Intervention	Description
T2DM Medical Nutrition Therapy	Control Group	Participants from control groups will receive the usual care, which will be a three-monthly nutrition consultation by a visiting dietitian
T2DM Medical Nutrition Therapy and Text Messages	Intervention Group	Participants from the intervention group will receive the usual care and an additional three text messages per week via WhatsApp over the 6-month intervention period

Primary Outcome Measures

Name	Time	Method
Comparison of dietary adherence at 3-month and 6-month between the usual care group and intervention group	Baseline, 3-month, and 6-month	Dietary adherence to diabetic diet will be evaluated against a modified healthy eating index (HEI). A 3-day dietary record methodology (2 weekdays and 1 weekend) will be used and analyzed based on Malaysian and Singapore Food Composition Databases. The modified version of HEI used in this study consists of 14 components. Sum scores of each component yields and overall score of diet quality which will be converted into scale of zero to 100. A higher the HEI score indicates a greater adherence. The overall dietary adherence will be classified as low (below 51%), needing improvement (51-80%), or high (more than 80 points)

Secondary Outcome Measures

Name	Time	Method
Comparison of glycated hemoglobin (HbA1c) at 3-month and 6-month between the usual care group and intervention group	Baseline, 3-month, and 6-month	Change in HbA1c will be determined by blood test at baseline, 3 and 6 months. The HbA1c result will be retrieved from the participants' routine blood result at health clinic or hospital, which will be analyzed following a standardized analytic protocol of Ministry of Health, Malaysia
Comparison of self-management behavior at 3-month and 6-month between the usual care group and intervention group	Baseline, 3-month, and 6-month	The Malay version of the Summary of Diabetes Self-Care Activities (SDSCA) will be used to measure diabetes self-management activities. The SDSCA will be used to examine the participants' compliance in performing five main self-care activities. The degree of compliance or frequency with which the person engages in each self-care behavior is considered when interpreting the SDSCA scores. Higher ratings across the board typically suggest better adherence and more active diabetes self-management.

Locations (1): Ranau District Hospital and Klinik Kesihatan Kundasang
🇲🇾
Kota Kinabalu, Sabah, Malaysia