N/A N=366 Randomized Single-blind Health Services Research

Diabetes Disparities: Texting to Extend Treatment (DD-TXT)

Diabetes Mellitus, Type 2

Bottom Line

View on ClinicalTrials.gov: NCT04227379 ↗

Enrolled (actual)

366

Serious AEs

0.8%

Results posted

Jun 2026

Primary outcome: Primary: Change in HbA1c Percent Time in Control — 23.41; 21.61 percent (%) of time in control — p=.6519

Study Design & Population

Study type: Interventional
Phase: N/A
Interventions: Intervention 1- DSMS+ (Behavioral); Comparison - DSMS (Behavioral)
Age: Adult, Older Adult · 18+ yrs
Sex: All
Sponsor: VA Office of Research and Development
Primary completion: Apr 2025

Outcome Measures

Outcome	Result	p-value
PRIMARY Change in HbA1c Percent Time in Control	23.41; 21.61	.6519
PRIMARY Change in HbA1c	-0.36; -0.40	.7552
SECONDARY Change in LDL	2.88; -7.68	.0351 sig
SECONDARY Change in Systolic Blood Pressure	-2.62; -2.29	.8155
SECONDARY Change in Diastolic Blood Pressure	-0.77; -0.65	.8648
SECONDARY Change in Self-reported Adherence to Diabetes Self-care Recommendations (SCI-R)	6.57; 5.23	.3334
SECONDARY Change in Self-reported Diabetes Self-efficacy Scale (DSES)	.03; .41	.0515
SECONDARY Change in Self-reported Diabetes Distress Scale (DDS17)	-.13; -.32	.0857
SECONDARY Change in Self-reported DDS17 Emotional Burden Subscale	-.14; -.45	.0326 sig
SECONDARY Change in Self-reported DDS17 Physician-related Distress Subscale	-.13; -.20	.5892
SECONDARY Change in Self-reported DDS17 Regimen-Related Distress Subscale	-.23; -.55	.0183 sig
SECONDARY Change in Self-reported DDS17 Interpersonal Distress Subscale	.08; -.18	.0583
SECONDARY Change in Self-reported Adherence to Refills and Medications Scale for Diabetes (ARMS-D)	-1.20; -.67	.1758
SECONDARY Change in Self-reported Physical Health Summary Score	.79; 1.09	.7527
SECONDARY Change in Self-reported Mental Health Summary Score	-0.02; 1.02	.3626

Summary

One way to help Veterans improve their diabetes control is through the use of technology to help provide information, motivation, and reminders necessary to support diabetes self-management. The study will seek input from diverse groups of Veterans living with diabetes to help develop a new customizable, interactive texting intervention that allows Veterans to choose what kinds of diabetes self-management support they need, and when. This diabetes support will be provided to Veterans through "Annie for Veterans", a VA texting system for self-management support. Patients will be randomized to receive a once-daily standard diabetes self-management texting intervention called DSMS based on standard diabetes self-management education content or a customizable, patient-centered diabetes self-management support intervention with additional features called DSMS Plus (DSMS+) in order to test the comparative effectiveness of these two texting interventions.

Eligibility Criteria

Inclusion Criteria

Veterans
Active VHA patients with type 2 diabetes
Had at least 4 VA outpatient encounters in the previous year
Have a future appointment scheduled, and not be hospitalized or institutionalized or have participated in texting intervention development
Have HbA1c lab data (2+ values) in the 12 months prior to RCT recruitment.
Have inadequate glycemic control for at least 50% of the 6 months before invitation to participate

Exclusion Criteria

Non-Veterans
Not having access to their own or a cohabiting family member's cell phone or smartphone for participation
Not willing and able to text
A visual impairment that would prevent them from reading or replying to text messages
Cognitively incapable of consent to participate (Failure of Short Blessed Test)

View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT04227379). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.