Research Summary

Analyzed using Evidence Intelligence™

Text Messaging Program Shows Little Effect on Diabetes Risk Factors

Last updated July 7, 2026

Key finding

7/57 (12%) intervention and 6/56 (11%) control participants met the primary outcome (relative risk, 1.08; 95%CI, 0.63–1.85; p = 0.79).

This study evaluated a text messaging-based lifestyle support program for women with gestational diabetes. Results showed no significant differences in key health outcomes compared to a control group.

Quick read

Study at a glance

The essential study design details in one scan.

EvidenceScore™

Moderate

Study type

RCTs

Follow-up

Medium-Term (3–12 mo)

Risk of bias

Some Concerns

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Plain-language summary

What this paper says

A plain-language read of the study’s main message and where it applies.

Study focus

Clinical relevance

Understanding the effectiveness of lifestyle interventions for women with gestational diabetes is crucial, as these programs aim to improve health outcomes for both mothers and their infants. The lack of significant findings suggests that alternative approaches may be needed to support this population effectively.

Keep in mind

Small sample sizes may limit the power of the study. No significant differences were found in key health outcomes. The generalizability of findings may be restricted to similar populations.

Published in

Journal Reference

Publication details and source links for this paper.

Ngai WC, David S, Simone M, et al. Smart Mums with Smart Phones 2: A Randomized Controlled Trial of a Text Messaging-Based Lifestyle Support Program for Women with Gestational Diabetes. Nutrients. 2024;16(6):820. doi:10.3390/nu16060820

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Main Effects

12% of intervention participants met the healthy lifestyle outcome compared to 11% in the control group (RR 1.08, p = 0.79).

30% of intervention participants achieved weight goals versus 19% in the control group (RR 1.54, p = 0.17).

47% of intervention participants met physical activity goals compared to 63% in the control group (RR 0.72, p = 0.08).

Evidence network

How this study fits

Understand where this research contributes within the broader evidence network.

Evidence Context

This study contributes evidence to Peer-support lifestyle program and BMI, Composite of Weight, Physical Activity, and Dietary Goals, Physical activity level (MET-minutes per week), and 7 more.

This study contributes evidence to

Intervention

Peer-support lifestyle program

Outcome

BMI

Evidence topic

Prediabetes

Primary intervention

Peer-support lifestyle program

Primary outcomes

BMI
Composite of Weight, Physical Activity, and Dietary Goals
Physical activity level (MET-minutes per week)

Evidence topics

Prediabetes Physical Activity Levels Treatment Adherence Weight Loss

Primary intervention

Peer-support lifestyle program

Primary outcomes

BMI Composite of Weight, Physical Activity, and Dietary Goals Physical activity level (MET-minutes per week)

Evidence relationships

Intervention and outcome relationships this study adds to the evidence network.

Evidence pairs

Relationships

Evidence topics

contributes_evidence

Editorial context

Why this study matters

See why this paper is useful beyond its individual results.

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.

Moderate contributionModerate confidenceNetwork score: 68

Why it is useful

Contributes to 10 evidence relationships
Includes primary outcome data
Linked to 5 direct semantic evidence topics

Topic contributions

Evidence topic

Contributes evidence

Evidence topic

Contributes evidence

Evidence topic

Contributes evidence

Evidence topic

Contributes evidence

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Primary evidence

Evidence relationship

Diabetes Self-Management Education and Support (DSMES) Programs and Body Mass Index

Related evidence

Evidence relationship

Diabetes Self-Management Education and Support (DSMES) Programs and Physical Activity Levels

Save evidence

Evidence topic

Prediabetes

Save evidence

Core evidence

Study findings

The primary outcomes reported in this study.

BMI

Peer-support lifestyle program → BMI

Evidence Intelligence™

EvidenceScore™: Emerging; Score 59 · Based on 1 study
ImpactScore™: 50; Neutral
ConsistencyScore™: unclear; Not enough independent studies

Based on 1 study

Add to Evidence Tracker

Composite of Weight, Physical Activity, and Dietary Goals

Peer-support lifestyle program → Composite of Weight, Physical Activity, and Dietary Goals

Evidence Intelligence™

EvidenceScore™: Emerging; Score 59 · Based on 1 study
ImpactScore™: 50; Neutral
ConsistencyScore™: unclear; Not enough independent studies

Based on 1 study

Add to Evidence Tracker

Physical activity level (MET-minutes per week)

Peer-support lifestyle program → Physical activity level (MET-minutes per week)

Evidence Intelligence™

EvidenceScore™: Strong; Score 79 · Based on 3 studies
ImpactScore™: 67; Slightly Positive
ConsistencyScore™: 67; generally_consistent

Based on 3 studies

Add to Evidence Tracker

Proportion of participants breastfeeding at 1 month

Peer-support lifestyle program → Proportion of participants breastfeeding at 1 month

Evidence Intelligence™

EvidenceScore™: Emerging; Score 59 · Based on 1 study
ImpactScore™: 50; Neutral
ConsistencyScore™: unclear; Not enough independent studies

Based on 1 study

Add to Evidence Tracker

Proportion of participants breastfeeding at 6 months

Peer-support lifestyle program → Proportion of participants breastfeeding at 6 months

Evidence Intelligence™

EvidenceScore™: Emerging; Score 59 · Based on 1 study
ImpactScore™: 50; Neutral
ConsistencyScore™: unclear; Not enough independent studies

Based on 1 study

Add to Evidence Tracker

Proportion of participants meeting dietary goal

Peer-support lifestyle program → Proportion of participants meeting dietary goal

Evidence Intelligence™

EvidenceScore™: Emerging; Score 59 · Based on 1 study
ImpactScore™: 50; Neutral
ConsistencyScore™: unclear; Not enough independent studies

Based on 1 study

Add to Evidence Tracker

Proportion of participants meeting weight goal

Peer-support lifestyle program → Proportion of participants meeting weight goal

Evidence Intelligence™

EvidenceScore™: Emerging; Score 59 · Based on 1 study
ImpactScore™: 50; Neutral
ConsistencyScore™: unclear; Not enough independent studies

Based on 1 study

Add to Evidence Tracker

Proportion of participants who had an OGTT performed by 12 weeks postpartum

Peer-support lifestyle program → Proportion of participants who had an OGTT performed by 12 weeks postpartum

Evidence Intelligence™

EvidenceScore™: Emerging; Score 59 · Based on 1 study
ImpactScore™: 50; Neutral
ConsistencyScore™: unclear; Not enough independent studies

Based on 1 study

Add to Evidence Tracker

Proportion of participants with EPDS score ≥ 10

Peer-support lifestyle program → Proportion of participants with EPDS score ≥ 10

Evidence Intelligence™

EvidenceScore™: Emerging; Score 59 · Based on 1 study
ImpactScore™: 50; Neutral
ConsistencyScore™: unclear; Not enough independent studies

Based on 1 study

Add to Evidence Tracker

Total physical activity time in minutes per week

Peer-support lifestyle program → Total physical activity time in minutes per week

Evidence Intelligence™

EvidenceScore™: Emerging; Score 59 · Based on 1 study
ImpactScore™: 50; Neutral
ConsistencyScore™: unclear; Not enough independent studies

Based on 1 study

Add to Evidence Tracker

Evidence Library

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Evidence Suggest

No significant improvement in healthy lifestyle outcomes (RR 1.08, p = 0.79).
Weight goal achievement was higher in the intervention group but not statistically significant (RR 1.54, p = 0.17).
Physical activity goal achievement was lower in the intervention group (RR 0.72, p = 0.08).

Who this applies to

Women diagnosed with gestational diabetes.
Participants in lifestyle intervention studies.

Keep in Mind

Results may not apply to all demographics of women with gestational diabetes.
Further research is needed to explore more effective interventions.
The study's findings may not reflect long-term outcomes beyond the intervention period.

Between the Lines

Small sample sizes may limit the power of the study.
No significant differences were found in key health outcomes.
The generalizability of findings may be restricted to similar populations.

Evidence Library

Build your evidence library

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Connected Evidence

Explore related studies, evidence collections, and research questions.

Relationships organized using the Dediabetes Evidence Intelligence™ framework.

This study contributes to evidence on Diabetes Self-Management Education and Support (DSMES) Programs and Physical Activity Levels, Diabetes Self-Management Education and Support (DSMES) Programs and Proportion of participants breastfeeding at 6 months.

Related evidence relationships

Explore in Evidence Explorer

This study contributes to the evidence on the following intervention-outcome relationships.

Behavioral & Lifestyle

Detailed evidence

Diabetes Self-Management Education and Support (DSMES) Programs → Physical Activity Levels

Behavioral & Lifestyle

Evidence Intelligence™

EvidenceScore™: Strong; Score 79 · Based on 3 studies
ImpactScore™: 67; Slightly Positive
ConsistencyScore™: 67; generally_consistent

Based on 3 studies

View evidence

Behavioral & Lifestyle

Detailed evidence

Diabetes Self-Management Education and Support (DSMES) Programs → Proportion of participants breastfeeding at 6 months

Behavioral & Lifestyle

Evidence Intelligence™

EvidenceScore™: Emerging; Score 59 · Based on 1 study
ImpactScore™: 50; Neutral
ConsistencyScore™: unclear; Not enough independent studies

Based on 1 study

View evidence

Behavioral & Lifestyle

Detailed evidence

Diabetes Self-Management Education and Support (DSMES) Programs → Proportion of participants meeting weight goal

Behavioral & Lifestyle

Evidence Intelligence™

EvidenceScore™: Emerging; Score 59 · Based on 1 study
ImpactScore™: 50; Neutral
ConsistencyScore™: unclear; Not enough independent studies

Based on 1 study

View evidence

Included in these evidence collections

Curated evidence collections and hubs this study is part of.

Diabetes Self-Management Education and Support (DSMES) Programs Evidence Hub

All studies on Diabetes Self-Management Education and Support (DSMES) Programs

3 studies

intervention_hub

Contributes to Diabetes Self-Management Education and Support (DSMES) Programs evidence base.

Physical Activity Levels Evidence Hub

All studies measuring Physical Activity Levels

3 studies

outcome_hub

Measures Physical Activity Levels as a key outcome.

Proportion of participants breastfeeding at 6 months Evidence Hub

All studies measuring Proportion of participants breastfeeding at 6 months

1 studies

outcome_hub

Measures Proportion of participants breastfeeding at 6 months as a key outcome.

Proportion of participants meeting weight goal Evidence Hub

All studies measuring Proportion of participants meeting weight goal

1 studies

outcome_hub

Measures Proportion of participants meeting weight goal as a key outcome.

Recent Diabetes Research

Latest published studies

recency_collection

Published within the last 2 years.

Explore more in Evidence Explorer

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All studies on Peer-support lifestyle program and Physical activity level (MET-minutes per week)

Intervention: Peer-support lifestyle programOutcome: Physical activity level (MET-minutes per week)

3 results

All studies on Peer-support lifestyle program and Proportion of participants breastfeeding at 6 months

Intervention: Peer-support lifestyle programOutcome: Proportion of participants breastfeeding at 6 months

1 results

All studies on Peer-support lifestyle program

Intervention: Peer-support lifestyle program

3 results

All studies measuring Physical activity level (MET-minutes per week)

Outcome: Physical activity level (MET-minutes per week)

3 results

All studies measuring Proportion of participants breastfeeding at 6 months

Outcome: Proportion of participants breastfeeding at 6 months

1 results

Questions answered by this study

Generated from the study's connected evidence using Evidence Intelligence™.

Does Diabetes Self-Management Education and Support (DSMES) Programs affect body mass index?

Strong Evidence

Diabetes Self-Management Education and Support (DSMES) Programs may improve Body Mass Index.

ConsistencyScore™: Results are generally consistent across studies.

Ranked evidence signals

1
BMI
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study

Why this answer: This answer is based on 15 supporting studies with generally consistent results and a positive effect signal.

Limitations

Population details are unavailable.

View Full Evidence

Does Diabetes Self-Management Education and Support (DSMES) Programs improve physical activity levels?

Strong Evidence

Diabetes Self-Management Education and Support (DSMES) Programs may improve Physical Activity Levels.

ConsistencyScore™: Results are mixed and should be interpreted cautiously.

Evidence caveat: The available evidence reports mixed findings.

Ranked evidence signals

1
Physical activity level (MET-minutes per week)
EvidenceScore™ Strong | EvidenceScore™ 79.0 | weak positive | ConsistencyScore™ Generally Consistent | 1 study

Why this answer: This answer is cautious because the available studies report mixed findings.

Limitations

Population details are unavailable.

View Full Evidence

Does Peer-support lifestyle program improve composite of weight, physical activity, and dietary goals?

Emerging Evidence

Current evidence does not show a clear benefit of Peer-support lifestyle program for Composite of Weight, Physical Activity, and Dietary Goals.

ConsistencyScore™: Consistency cannot yet be determined from the available evidence.

Ranked evidence signals

1
Composite of Weight, Physical Activity, and Dietary Goals
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study

Why this answer: This answer is based on a single supporting study.

Limitations

Only one supporting study is available.
Consistency cannot yet be determined.
Population details are unavailable.

View Full Evidence

Does Peer-support lifestyle program improve proportion of participants breastfeeding at 1 month?

Emerging Evidence

Current evidence does not show a clear benefit of Peer-support lifestyle program for Proportion of participants breastfeeding at 1 month.

ConsistencyScore™: Consistency cannot yet be determined from the available evidence.

Ranked evidence signals

1
Proportion of participants breastfeeding at 1 month
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study

Why this answer: This answer is based on a single supporting study.

Limitations

Only one supporting study is available.
Consistency cannot yet be determined.
Population details are unavailable.

View Full Evidence

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Next steps

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Evidence topics

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Prediabetes Evidence Hub Physical Activity Levels Evidence Hub Treatment Adherence Evidence Hub Weight Loss Evidence Hub

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All studies on Peer-support lifestyle program and Composite of Weight, Physical Activity, and Dietary Goals All studies on Peer-support lifestyle program and Physical activity level (MET-minutes per week)All studies on Peer-support lifestyle program and BMI All studies on Peer-support lifestyle program and Proportion of participants breastfeeding at 1 month

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