Effectiveness of Digital Delivery of Diabetes-Related Lifestyle Interventions in Decreasing A1c: A Systematic Review

Abstract

Background: Digital delivery of lifestyle interventions offers a potentially effective, affordable, and convenient option for patients to prevent and monitor type 2 diabetes (T2D) (Khan et al., 2019). Hemoglobin A1c (A1c) is a measure used to monitor T2D progression. Standard of care- based approaches to encourage lifestyle modification have been shown to decrease A1c, yet high healthcare costs and travel-related barriers limit the accessibility of these strategies. Rising T2D rates globally underscore the immediate need to identify the most comparably effective options that decrease A1c and address disease prevention and management. Objectives: This systematic review examines the effectiveness of digital delivery of lifestyle interventions in decreasing A1c among adults globally both overall and compared to standard of care and monitoring only based approaches. Methods: Based on application of the Navigation Guide systematic review methodology, 10 studies conducted in eight countries met the inclusion criteria and were evaluated for bias, quality, and strength of evidence. Conclusions were drawn from evaluating quantitative results. Results: A systematic review of the literature demonstrated sufficient evidence of an association between digital delivery of lifestyle interventions and decreased A1c trends. Research did not show significant differences in A1c changes among the intervention groups when compared to the standard of care and monitoring only based control groups. Conclusions: These results indicate that while the digital delivery of lifestyle interventions is effective in lowering A1c levels in T2D patients, these interventions do not outperform standard of care and monitoring only based approaches to prevent and manage T2D.