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

Effectiveness of Text Messaging Intervention to Improve Dietary Behaviors Among Patients with Type 2 Diabetes Mellitus in Low Resource Area of Sabah: a Randomized, Open-Label, Controlled Trial

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

Inclusion Criteria:

• have type 2 diabetes.
• own a mobile phone.
• able to use WhatsApp.
• able to read and speak Bahasa Malaysia.
• have an HbA1c level above 7.0%.
• have not seen a dietitian in the previous 6 months.

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.