What question did this study set out to answer?

This research aims to compare the retention of diabetes self-management education across different delivery modalities in Latino adults with type 2 diabetes.

June 7, 2026

2752-LB: Text-Based DSMES Demonstrates Higher Retention than Live Delivery: Preliminary Findings from a Pilot Randomized Trial

Key Points

This research aims to compare the retention of diabetes self-management education across different delivery modalities in Latino adults with type 2 diabetes.
Pilot randomized trial with 64 Latino adults with type 2 diabetes and HbA1c ≥7.5%
Participants randomized to text-based, telehealth, or in-person DSMES delivery
Retention measured through completion of intervention and assessments at 3 and 6 months
Overall retention was 53%, with text-based retention at 65%, telehealth at 44%, and in-person at 29%.
Text-based DSMES showed 10-fold higher retention compared to telehealth (OR=0.11; 95% CI=0.02, 0.62; p=.012) and in-person delivery (OR=0.10; 95% CI=0.02, 0.55; p=.008).
Employment status was strongly associated with retention (OR=7.12; p=.011).

Abstract

Introduction and Objective: Diabetes self-management education and support (DSMES) improves glycemic management, yet high attrition rates limit effectiveness, particularly among Latino populations. This study used data from an ongoing pilot randomized trial to compare retention by sociodemographic factors across DSMES delivery modalities among Latino adults with type 2 diabetes (T2D). Methods: Participants (N=64) with HbA1c ≥7.5% who completed baseline and initiated intervention were included in retention analyses; participants were randomized to one of the three DSMES delivery modality: (1) text-based (n=34), (2) live telehealth (n=16), or (3) live in-person (n=14). Retention was defined as completing the intervention and 3- and 6-month assessments. A multivariable logistic regression model was fitted to predict retention, including delivery modality and sociodemographic covariates (age, education, employment) simultaneously, yielding mutually adjusted estimates. Results: Overall retention was 53% and varied by modality: text-based=65%, telehealth=44%, in-person=29%. After adjusting for sociodemographic factors, text-based DSMES demonstrated 10-fold higher retention vs telehealth (OR=0.11; 95% CI=0.02, 0.62; p=.012) and in-person delivery (OR=0.10; 95% CI=0.02, 0.55; p=.008). Employment status was the strongest predictor (OR=7.12; 95% CI=1.56, 32.56; p=.011), with unemployed/retired participants showing substantially higher retention. Age showed marginal association (OR=1.06; p=.058) while education was non-significant (p=.573). Conclusion: Text-based DSMES demonstrated higher retention than live delivery after adjusting for sociodemographic factors. Employment status strongly predicted retention, suggesting that DSMES programs using asynchronous delivery formats may better accommodate working Latino populations facing barriers to real-time participation. Disclosure E. San Diego: None. M. Ruiz: None. G.G. Ramon: None. E. Pyatak: None. M.M. Hughes: None. A.B. Nerey: None. S. Sanchez: None. S. Subramanian: None. A. Philis-Tsimikas: Research Support; Current; Dexcom, Inc., Lilly, Novo Nordisk. Advisory Panel; Current; Novo Nordisk, Gan Current; Sanofi-Aventis U.S. Funding National Institutes of Health (K01DK140528; P50MD017344); Merck (#60691)

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