Efficacy of eHealth Interventions for Adults with Diabetes: A Systematic Review and Meta-Analysis

Abstract

The aim is to provide meta-analytical evidence on eHealth interventions’ efficacy in supporting the psychosocial and physical well-being of adults with type 1 or type 2 Diabetes Mellitus (DM), and to investigate differences in interventions primarily targeted at providing glycemic control vs. psychosocial support. A PRISMA-guided systematic search was conducted. Randomized Controlled Trials (RCTs) regarding eHealth interventions for adults (18–65 years) with DM were included. Data were pooled using Standard Mean Difference (SMD); sub-group analysis and meta-regressions were performed when appropriate. Outcomes were Hemoglobin A1c (HbA1c), diabetes distress, quality of life, anxiety, stress, and depression. Intervention acceptability was assessed performing the Odds Ratio (OR) of drop-out rates. Thirteen RCTs comprising 1315 participants were included (52.09% females; Mage = 46.18, SD = 9.98). Analyses showed intervention efficacy on HbA1c (SMD = −0.40; 95% CI = −0.70, −0.12; k = 13) and depressive symptoms (SMD = −0.18; 95% CI = −0.33, −0.02; k = 6) at RCTs endpoint and were well accepted (OR = 1.43; 95% CI = 0.72, 2.81; k = 10). However, efficacy on HbA1c was not maintained at follow-up (SMD = −0.13; 95% CI = −0.31, 0.05; k = 6). eHealth interventions providing medical support were acceptable and effective in fostering glycemic control and decreasing depressive symptoms in the short-term only. Digital solutions should be developed on multiple levels to fully support the psychophysical well-being of people with DM.

The Impact of the Covid-19 Pandemic on the Well-Being and Diabetes Management of Adolescents With Type 1 Diabetes and Their Caregivers: A Scoping Review

“…Lastly, this scoping review permitted to highlight the need to also consider psychosocial variables relevant to T1DM when investigating the impact of Covid-19, as the psychosocial components of the disease are influenced by the medical ones and vice versa. Indeed, both psychosocial and medical variables are bidirectionally associated ( 39 ) and they are comparably relevant for the investigation, prevention, and promotion of the broader well-being of adolescents with T1DM. In addition, the joint consideration of the two may be of practical benefit in better comprehending the whole functioning of adolescents with T1DM.…”

Perspectives on Promoting Physical Activity Using eHealth in Primary Care by Health Care Professionals and Individuals With Prediabetes and Type 2 Diabetes: Qualitative Study

“…Technology (ie, hardware, devices, and software) should be customized based on the patient’s needs, desires, skill level, and availability of devices [ 23 ]. The use of eHealth and mobile health interventions is a cost-effective approach that reaches many individuals with a high level of engagement in the short-term [ 24 , 25 ]. eHealth interventions also have had a considerable impact on physical activity and healthy eating.…”

Correlation between Glycation-Related Biomarkers and Quality of Life in the General Japanese Population: The Iwaki Cross-Sectional Research Study

“…It was suggested that digital solutions should be developed to fully support the psychophysical well-being of patients with diabetes mellitus [ 47 ]. Furthermore, our results suggested that a self-management system and intervention method for glycation prevention can help to improve QOL in the general population.…”