Document Type : Original Article



CONTEXT: Lifestyle modifications play a major role in controlling blood glucose levels among
diabetes mellitus for the prevention of its complications. Mobile phones can be used as an efficient
tool for improving the healthy lifestyle through health education.
AIMS: The aim of the study is to measure the efficacy of behavior change communication using
mobile calls in controlling blood sugar levels, increasing medication adherence, healthy diet, and
physical activity among diabetic patients.
SETTINGS AND DESIGN: A randomized controlled trial was conducted in an urban area of
Pondicherry between 50 (25 per arm) type 2 diabetes patients.
SUBJECTS AND METHODS: All participants were interviewed using a structured questionnaire.
Fasting blood glucose (FBG) was measured. Single‑time health education was given to both
groups. The intervention group received a mobile phone calls reminders thrice weekly for 2 months.
Changes in FBG, diet, physical activities, and adherence to medications were assessed after
2 months.
STATISTICAL ANALYSIS USED: Means and proportions were calculated. Chi‑square test and
paired t‑test were used to calculate the P value.
RESULTS: FBG increased significantly in the control group by 25.6 mg/dl (P = 0.03), whereas it
was only 6.5 mg/dl in the intervention group (P = 0.56). Adherence to medications was increased
significantly in both interventions (+21%) and control (+19%) groups. Number of fruits intake days
per week (+1, P = 0.01) and fruits serving per day (+0.5, P = 0.00) have increased significantly in
the intervention group. Recreational physical activity was increased in the intervention group but
not statistically significant.
CONCLUSION: Our study findings suggest that mobile phone calls might help to improve
glycemic control. It also suggests that it could improve the adherence to medications and
intake of fruits. In the future, studies with large sample size and longer intervention need to be


1. World Health Organization. Global Report on Diabetes, 2016.
Geneva: World Health Organization; 2016.
2. Deaths due to Diabetes in India. South East Asia Regional Fact
Sheet. Available from: [Last
accessed on 2016 Dec 23].
3. Haas L, Maryniuk M, Beck J, Cox CE, Duker P, Edwards L, et al.
National standards for diabetes self‑management education and
support. Diabetes Care 2014;37 Suppl 1:S144‑53.
4. Diabetes Complications. U.S. National Library of Medicine.
Rockville Pike, Bethesda, MD: U.S. Department of Health and
Human Services National Institutes of Health; 2016. Available
html. [Last accessed on 2016 Dec 19].
5. Stalin P, Singh Z, Purty AJ, Sharma Y, Abraham SB. Study
on prevalence and factors influencing patient’s adherence to
anti‑diabetic medications in urban Puducherry. Int J Diabetes
Dev Ctries 2015;35:128‑31.
6. Brown MT, Bussell JK. Medication adherence: WHO cares? Mayo
Clin Proc 2011;86:304‑14.
7. Bin Abbas B, Al Fares A, Jabbari M, El Dali A, Al Orifi F. Effect of
mobile phone short text messages on glycemic control in type 2
diabetes. Int J Endocrinol Metab 2015;13:e18791.
8. Arora S, Peters AL, Burner E, Lam CN, Menchine M. Trial to
examine text message‑based mHealth in emergency department
patients with diabetes (TExT‑MED): A randomized controlled
trial. Ann Emerg Med 2014;63:745‑54.
9. Cho JH, Lee HC, Lim DJ, Kwon HS, Yoon KH. Mobile
communication using a mobile phone with a glucometer for
glucose control in type 2 patients with diabetes: As effective as
an internet‑based glucose monitoring system. J Telemed Telecare
10. Shahid M, Mahar SA, Shaikh S, Shaikh ZU. Mobile phone
intervention to improve diabetes care in rural areas of Pakistan:
A randomized controlled trial. J Coll Physicians Surg Pak
11. Krishnamohan S, Stalin P, Singh Z, Sridhar M. Efficacy of health
education using facebook to promote healthy lifestyle among
medical students in Puducherry, India: A non‑randomized
controlled trial. J Clin Diagn Res 2017;11:LC07‑10.
12. Hussein WI, Hasan K, Jaradat AA. Effectiveness of mobile phone
short message service on diabetes mellitus management; the
SMS‑DM study. Diabetes Res Clin Pract 2011;94:e24‑6.
13. Shariful Islam SM, Niessen LW, Ferrari U, Ali L, Seissler J,
Lechner A, et al. Effects of mobile phone SMS to improve glycemic
control among patients with type 2 diabetes in bangladesh:
A prospective, parallel‑group, randomized controlled trial.
Diabetes Care 2015;38:e112‑3.