title: Text Message Support for Weight Loss in Patients With Prediabetes: A Randomized Clinical Trial.
abstract: Although the benefits of in-person Diabetes Prevention Program (DPP) classes for diabetes prevention have been demonstrated in trials, effectiveness in clinical practice is limited by low participation rates. This study explores whether text message support enhances weight loss in patients offered DPP classes.
  
  
  
  English- and Spanish-speaking patients with prediabetes (n = 163) were randomized to the control group, which only received an invitation to DPP classes as defined by the Centers for Disease Control and Prevention, or to the text message-augmented intervention group, which also received text messages adapted from the DPP curriculum for 12 months.
  
  
  
  Mean weight decreased 0.6 pounds (95% CI -2.7 to 1.6) in the control group and 2.6 pounds (95% CI -5.5 to 0.2) in the intervention group (P value 0.05). Three percent weight loss was achieved by 21.5% of participants in the control group (95% CI 12.5-30.6), compared with 38.5% in the intervention group (95% CI 27.7-49.3) (absolute difference 17.0%; P value 0.02). Mean glycated hemoglobin (HbA1c) increased by 0.19% or 2.1 mmol/mol (95% CI -0.1 to 0.5%) and decreased by 0.09% or 1.0 mmol/mol (95% CI -0.2 to 0.0%) in the control group and intervention participants, respectively (absolute difference 0.28%; P value 0.07). Stratification by language demonstrated a significant treatment effect in Spanish speakers but not in English speakers.
  
  
  
  Text message support can lead to clinically significant weight loss in patients with prediabetes. Further study assessing effect by primary language and in an operational setting is warranted.
authors: Denver Health and Hospital Authority, Denver, CO henry.fischer@dhha.org.
authors: Henry H
authors: HH
authors: Fischer
authors: Denver Health and Hospital Authority, Denver, CO.
authors: Ilana P
authors: IP
authors: Fischer
authors: Denver Health and Hospital Authority, Denver, CO University of Colorado School of Medicine, Aurora, CO.
authors: Rocio I
authors: RI
authors: Pereira
authors: Denver Health and Hospital Authority, Denver, CO.
authors: Anna L
authors: AL
authors: Furniss
authors: Denver Health and Hospital Authority, Denver, CO.
authors: Jeanne M
authors: JM
authors: Rozwadowski
authors: Denver Health and Hospital Authority, Denver, CO.
authors: Susan L
authors: SL
authors: Moore
authors: Denver Health and Hospital Authority, Denver, CO.
authors: Michael J
authors: MJ
authors: Durfee
authors: Denver Health and Hospital Authority, Denver, CO.
authors: Silvia G
authors: SG
authors: Raghunath
authors: University of Colorado School of Medicine, Aurora, CO Kaiser Permanente, Denver, CO.
authors: Adam G
authors: AG
authors: Tsai
authors: Denver Health and Hospital Authority, Denver, CO University of Colorado School of Medicine, Aurora, CO.
authors: Edward P
authors: EP
authors: Havranek
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000523:psychology / Q000628:therapy*; D012680:Sensitivity and Specificity; D060145:Text Messaging; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D006442:Glycated Hemoglobin