The Clinical Effects of Type 2 Diabetes Patient Management Using Digital Healthcare Technology: A Systematic Review and Meta-Analysis

Abstract

The disease control rate is very low (at less than 30%) for diabetes. The use of digital healthcare technology is increasing recently for continuous management in daily life. In this study, a meta-analysis was conducted to evaluate the clinical effects of digital healthcare technology for patients with type 2 diabetes management. For a review of the literature, databases such as PubMed, Embase, and Cochrane Library were searched using Medical Subject Heading (MeSH) terms published up to 9 August 2021. As a result, 2354 articles were identified, and 12 randomized controlled trial articles were finally included. Digital healthcare technology combined management for type 2 diabetes significantly decreased HbA1c (p < 0.00001, standardized mean difference (SMD) = −0.49) and marginally decreased triglyceride, compared with usual care (p = 0.06, SMD = −0.18). However, it did not significantly affect BMI (p = 0.20, SMD = −0.47), total cholesterol (p = 0.13, SMD = −0.19), HLD-C (p = 0.89, SMD = −0.01), LDL-C (p = 0.95, SMD = −0.01), systolic BP (p = 0.83, SMD = 0.03), or diastolic BP (p = 0.23, SMD = 0.65), compared with usual care. These results indicate that digital healthcare technology can improve HbA1c and triglyceride levels of type 2 diabetes patients. Further well-designed randomized controlled clinical trials are needed to confirm the clinical effect of digital healthcare technology.

Effectiveness of a Smartphone App to Promote Physical Activity Among Persons With Type 2 Diabetes: Randomized Controlled Trial

“…However, all of the evaluated apps included monitoring of blood glucose. The effects on other clinical markers including body weight, blood lipids, and blood pressure are less clear [38]. Our results are in line with the Sophia step study, where no effects on cardiometabolic variables, including HbA 1c , triglycerides, HDL cholesterol, and LDL cholesterol, were seen [37].…”

Improving the management of type 2 diabetes in China using a multifaceted digital health intervention in primary health care: the SMARTDiabetes cluster randomised controlled trial

“…This is consistent with the findings of a recent meta-analysis on the clinical effects of T2DM patient management using digital healthcare technology. 12 It is likely that additional strategies are needed to generate clinically meaningful improvements in these risk factors. In addition, we found the intervention was associated with an increase of almost three clinic visits per year.…”

“…In the past two decades, many randomized controlled trials (RCTs) and systematic reviews have been conducted to evaluate the effect of mHealth in diabetes management focussing on improving knowledge and behaviour change, 5 self-management skills, 6 , 7 adherence to medication, 8 and clinical outcomes. 9 , 10 , 11 , 12 However most of the literature is from hospital-based studies in high income countries, 12 with small sample sizes and short follow-up periods. 9 , 10 , 11 , 12 , 13 Clinical effects are highly variable and may relate to the diversity of the mHealth interventions studied.…”

“… 9 , 10 , 11 , 12 However most of the literature is from hospital-based studies in high income countries, 12 with small sample sizes and short follow-up periods. 9 , 10 , 11 , 12 , 13 Clinical effects are highly variable and may relate to the diversity of the mHealth interventions studied. Large scale evaluations based on real-world practice are needed to explore clinical effectiveness and implementation.…”

Connected Insulin Pens and Caps: An Expert’s Recommendation from the Area of Diabetes of the Spanish Endocrinology and Nutrition Society (SEEN)

“…Boluses after meals and excessive numbers of hyperglycaemia corrections cause difficult-to-manage hyperglycaemia and hypoglycaemia that impact the physical and mental health of people with diabetes. Maintaining a high glycaemic variability in the long term favours the development of endothelial dysfunction and, finally, cardiovascular events [ 14 ]. Low insulin adherence negatively influences quality of life and is associated with increased morbidity, mortality and hospitalisations due to acute complications [ 12 , 15 ].…”