Tim Ramsey
Principal Advisor
To mark World Health Day, we’re sharing the results of a trial helping people with diabetes in the Middle East and North Africa (MENA) region to reduce their blood sugar levels.
The MENA region presently has the highest regional prevalence of diabetes at 16.2%. Projected trends are troubling too: the diabetes rate is expected to grow by 86%, reaching 136 million by 2045. Without proper management, diabetes can lead to serious and chronic complications, including eye disease, cardiovascular diseases, and kidney failure.
In partnership with the national Health department, we ran an ambitious trial. It aimed to test whether supporting patients to make diet and lifestyle commitments (e.g., eating less rice) could lower blood sugar levels and BMI.
We didn’t find a significant effect on patients’ blood sugar. However, promising results for patients whose baseline blood sugar level was high offer interesting insights to build on for future work.
BIT conducted an evidence review and qualitative research in healthcare centres where the majority of people living with diabetes receive care. We found two broad issues that people with diabetes face:
To tackle these barriers, we ran a randomised controlled trial involving 624 patients in six PHCs to test two new interventions. We tested these against the existing information booklet that was provided to patients (control). The two treatments were:
Neither the healthy commitments nor the addition of the monitoring calls had a statistically significant effect on people’s blood sugar levels compared to the existing leaflet.
Results for the two treatments compared with the control. | Sub-group analysis exploring the difference between people with “controlled” and “uncontrolled’ blood sugar levels |
However, further exploratory analysis revealed an intriguing finding. Patients with high “uncontrolled” blood sugar, as compared to those with low “controlled” blood sugar, showed positive signs of impact (although these were also not statistically significant).
While we had originally intended to impact a wider target population, this particular finding illustrates the importance of conducting subgroup analyses in research through digging deep into the data. By doing so, behavioural scientists can uncover what interventions are most effective for specific subgroups, and ultimately, tailor our strategies to maximise impact. In other words, it’s not just about what works – but what works and for whom.
Principal Advisor
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