It is widely understood that young people are frequent users of information and communications technology.
Consequently, high-quality evidence to guide management of young-onset type 2 diabetes remains scarce. Overall, young adults with type 2 diabetes have been underrepresented in most clinical studies to date. However, participants in the Hong Kong study had a mean age of 63 years as a result, the benefit of SMS text message reminders in the young-onset type 2 diabetes setting remains to be established. A study from Hong Kong did identify a benefit of an SMS text message reminder for the attendance rate within a type 2 diabetes population at a primary care clinic.
However, the SMS4BG study did not specifically examine the impact of the program on clinic attendance, nor did it specifically target individuals with young-onset type 2 diabetes. In the field of diabetes, the SMS4BG study established that an SMS text messaging program could facilitate modest improvement in glycemic control. In adolescent medicine, SMS text message interventions have been used to address important issues, including teenage pregnancy and binge drinking of alcohol. The landmark TEXTME study demonstrated that a structured, lifestyle-based SMS text messaging program could improve cardiovascular risk factor management after myocardial infarction. In recent years, innovative text messaging interventions have yielded promising results in high-risk groups. As each clinical encounter provides an excellent opportunity to review a patient’s understanding of diabetes and its management, convey important messages relating to self-management, adjust pharmacotherapy, perform complications screening, and foster a therapeutic rapport, novel ideas are needed to motivate young adults with type 2 diabetes and encourage more reliable clinic attendance. An audit of clinic attendance at a metropolitan, hospital-based diabetes center clearly demonstrated that young adults with type 2 diabetes were the subgroup that had the highest rate of nonattendance median loss to follow-up time was approximately 4 months. There is specific evidence that clinic attendance associates with favorable outcomes in young-onset type 2 diabetes during the landmark Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) study of adolescent type 2 diabetes, it was established that participants who attended ≥75% of scheduled lifestyle education sessions achieved significantly greater weight reductions than those who attended less often. Suboptimal clinic attendance and poor engagement in self-management represent significant barriers to improving long-term outcomes. This is particularly concerning given the aggressive nature of young-onset type 2 diabetes, with high rates of complications, established premature mortality, and the poorest comparative outcomes.
The worldwide prevalence of young‑onset type 2 diabetes more than doubled during the decade spanning 2003 to 2013, and today, well in excess of 60 million young people are living with type 2 diabetes. Over the past 20 years, young‑onset type 2 diabetes (age of onset <40 years) has emerged as a significant clinical problem.
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