Last updated August 29, 2026
Key finding
There was a significant difference between groups in change in systolic blood pressure from baseline of 3.46 mmHg (1.48 to 5.44, P = 0.001) in favour of the intervention group.
This study evaluated the effectiveness of SMS-text messaging on improving health outcomes in adults with type 2 diabetes compared to usual care.
Quick read
The essential study design details in one scan.
EvidenceScore™
Moderate
Study type
RCTs
Follow-up
Long-Term (1–5 y)
Risk of bias
Some Concerns
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Plain-language summary
A plain-language read of the study’s main message and where it applies.
Study focus
This study evaluated the effectiveness of SMS-text messaging on improving health outcomes in adults with type 2 diabetes compared to usual care.
Improving blood pressure control is crucial for adults with type 2 diabetes, as it can reduce the risk of cardiovascular complications. The findings suggest that SMS-text messaging could be a valuable tool in diabetes management, potentially leading to better health outcomes.
The study did not find significant differences in HbA1c and medication adherence. The sample size and population characteristics may limit generalizability. The trial focused on short-term outcomes; long-term effects were not assessed.
Published in
Publication details and source links for this paper.
A. F, K. B, N. L, et al. Effectiveness of SMS-text messaging in improving outcomes in adults with type 2 diabetes: a randomized controlled trial. BMC Public Health. 2021;21:1907. doi:10.1186/s12889-021-11874-7
Systolic blood pressure decreased significantly by 3.46 mmHg in the SMS group (P = 0.001).
The proportion of participants reaching treatment goals was higher in the SMS group (36.0%) compared to the control group (26.8%) with a relative risk of 1.36 (P = 0.001).
No significant change was observed in HbA1c levels between groups (−0.08%, P = 0.45).
Evidence network
Understand where this research contributes within the broader evidence network.
This study contributes evidence to SMS text messaging behavioral intervention for health promotion and 10-year risk of coronary heart disease, HbA1c, Proportion of participants reaching treatment goals, and 2 more.
This study contributes evidence to
Primary intervention
SMS text messaging behavioral intervention for health promotion
Primary outcomes
Intervention and outcome relationships this study adds to the evidence network.
Editorial context
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Evidence network role
This section describes how the study fits into the current evidence network. It does not determine whether an intervention works on its own.
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Evidence pairs
751
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Contributes evidence
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Contributes evidence
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Contributes evidence
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Primary evidence
Evidence relationship
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Core evidence
The primary outcomes reported in this study.
SMS text messaging behavioral intervention for health promotion → 10-year risk of coronary heart disease
SMS text messaging behavioral intervention for health promotion → 10-year risk of coronary heart disease
SMS text messaging behavioral intervention for health promotion → HbA1c
SMS text messaging behavioral intervention for health promotion → HbA1c
SMS text messaging behavioral intervention for health promotion → Proportion of participants reaching treatment goals
SMS text messaging behavioral intervention for health promotion → Proportion of participants reaching treatment goals
SMS text messaging behavioral intervention for health promotion → Proportion of patients collecting more than 80% of prescribed medication
SMS text messaging behavioral intervention for health promotion → Proportion of patients collecting more than 80% of prescribed medication
SMS text messaging behavioral intervention for health promotion → Systolic blood pressure
SMS text messaging behavioral intervention for health promotion → Systolic blood pressure
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Relationships organized using the Dediabetes Evidence Intelligence™ framework.
This study contributes to evidence on Diabetes Self-Management Education and Support (DSMES) Programs and HbA1c, Diabetes Self-Management Education and Support (DSMES) Programs and Blood Pressure.
This study contributes to the evidence on the following intervention-outcome relationships.
Behavioral & Lifestyle
Behavioral & Lifestyle
Curated evidence collections and hubs this study is part of.
All studies on Diabetes Self-Management Education and Support (DSMES) Programs
Contributes to Diabetes Self-Management Education and Support (DSMES) Programs evidence base.
All studies measuring HbA1c
Measures HbA1c as a key outcome.
All studies measuring Blood Pressure
Measures Blood Pressure as a key outcome.
Jump to pre-filtered views in Evidence Explorer.
6 results
2 results
6 results
6 results
2 results
Generated from the study's connected evidence using Evidence Intelligence™.
Diabetes Self-Management Education and Support (DSMES) Programs may improve Blood Pressure.
ConsistencyScore™: Results are mixed and should be interpreted cautiously.
Ranked evidence signals
Systolic blood pressure
EvidenceScore™ Moderate | EvidenceScore™ 69.0 | strong positive | ConsistencyScore™ Consistent | 1 study
Why this answer: This answer is cautious because the available studies report mixed findings.
Limitations
Diabetes Self-Management Education and Support (DSMES) Programs may improve HbA1c.
ConsistencyScore™: Results are generally consistent across studies.
Ranked evidence signals
HbA1c
EvidenceScore™ Strong | EvidenceScore™ 83.0 | weak positive | ConsistencyScore™ Consistent | 1 study
Why this answer: This answer is based on 41 supporting studies with generally consistent results and a positive effect signal.
Limitations
SMS text messaging behavioral intervention for health promotion appears to improve Proportion of participants reaching treatment goals.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Proportion of participants reaching treatment goals
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Current evidence does not show a clear benefit of SMS text messaging behavioral intervention for health promotion for 10-year risk of coronary heart disease.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
10-year risk of coronary heart disease
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
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