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T2DM Self-Management via Smartphone Applications: A Systematic Review and Meta-Analysis

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  • Mingxuan Cui
  • Xueyan Wu
  • Jiangfeng Mao
  • Xi Wang
  • Min Nie

Abstract

Background: Mobile health interventions (mHealth) based on smartphone applications (apps) are promising tools to help improve diabetes care and self-management; however, more evidence on the efficacy of mHealth in diabetes care is needed. The objective of this study was to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) assessing the effect of mHealth apps on changes in hemoglobin A1c (HbA1c), blood glucose, blood pressure, serum lipids, and body weight in type 2 diabetes mellitus (T2DM) patients. Methods: Two independent reviewers searched three online databases (PubMed, the Cochrane Library, and EMBASE) to identify relevant studies published between January 2005 and June 2016. Of the 2,596 articles retrieved, 13 RCTs were included. We used random effects model to estimate the pooled results. Results: Thirteen studies were selected for the systematic review, six of which with data available containing 1,022 patients were included for the meta-analysis. There was a moderate effect on glycemic control after the mHealth app-based interventions. The overall effect on HbA1c shown as mean difference (MD) was -0.40% (-4.37 mmol/mol) (95% confidence interval [CI] -0.69 to -0.11% [-7.54 to -1.20 mmol/mol]; p = 0.007) and standardized mean differences (SMD) was -0.40% (-4.37 mmol/mol) (95% confidence interval [CI] -0.69 to -0.10% [-7.54 to -1.09 mmol/mol]; p = 0.008). A subgroup analysis showed a similar effect with -0.33% (-3.61 mmol/mol) (95% CI -0.59 to -0.06% [-6.45 to -0.66 mmol/mol]; p = 0.02) in MD and -0.38% (-4.15 mmol/mol) (95% CI -0.71 to -0.05% [-7.76 to -0.55 mmol/mol]; p = 0.02) in SMD in studies where patients’ baseline HbA1c levels were less than 8.0%. No effects of mHealth app interventions were found on blood pressure, serum lipids, or weight. Assessment of overall study quality and publication bias demonstrated a low risk of bias among the six studies. Conclusions: Smartphone apps offered moderate benefits for T2DM self-management. However, more research with valid study designs and longer follow-up is needed to evaluate the impact of mHealth apps for diabetes care and self-management.

Suggested Citation

  • Mingxuan Cui & Xueyan Wu & Jiangfeng Mao & Xi Wang & Min Nie, 2016. "T2DM Self-Management via Smartphone Applications: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 11(11), pages 1-15, November.
    • Handle: RePEc:plo:pone00:0166718
    DOI: 10.1371/journal.pone.0166718
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    References listed on IDEAS

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    1. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
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    1. Sungwon Yoon & Yu Heng Kwan & Jie Kie Phang & Wee Boon Tan & Lian Leng Low, 2022. "Personal Goals, Barriers to Self-Management and Desired mHealth Application Features to Improve Self-Care in Multi-Ethnic Asian Patients with Type 2 Diabetes: A Qualitative Study," IJERPH, MDPI, vol. 19(22), pages 1-13, November.
    2. Hao Wang & Amy F. Ho & R. Constance Wiener & Usha Sambamoorthi, 2021. "The Association of Mobile Health Applications with Self-Management Behaviors among Adults with Chronic Conditions in the United States," IJERPH, MDPI, vol. 18(19), pages 1-11, September.
    3. Anish Menon & Farhad Fatehi & Dominique Bird & Darsy Darssan & Mohan Karunanithi & Anthony Russell & Leonard Gray, 2019. "Rethinking Models of Outpatient Specialist Care in Type 2 Diabetes Using eHealth: Study Protocol for a Pilot Randomised Controlled Trial," IJERPH, MDPI, vol. 16(6), pages 1-11, March.
    4. Surya Roca & María Luisa Lozano & José García & Álvaro Alesanco, 2021. "Validation of a Virtual Assistant for Improving Medication Adherence in Patients with Comorbid Type 2 Diabetes Mellitus and Depressive Disorder," IJERPH, MDPI, vol. 18(22), pages 1-17, November.
    5. Eun-Young Lee & Jae-Seung Yun & Seon-Ah Cha & Sun-Young Lim & Jin-Hee Lee & Yu-Bae Ahn & Kun-Ho Yoon & Seung-Hyun Ko, 2021. "Personalized Type 2 Diabetes Management Using a Mobile Application Integrated with Electronic Medical Records: An Ongoing Randomized Controlled Trial," IJERPH, MDPI, vol. 18(10), pages 1-11, May.
    6. Louise Poppe & Geert Crombez & Ilse De Bourdeaudhuij & Celien Van der Mispel & Samyah Shadid & Maïté Verloigne, 2018. "Experiences and Opinions of Adults with Type 2 Diabetes Regarding a Self-Regulation-Based eHealth Intervention Targeting Physical Activity and Sedentary Behaviour," IJERPH, MDPI, vol. 15(5), pages 1-11, May.

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