OBJECTIVES: Digital health interventions (DHI) have enormous potential as tools to improve health and healthcare delivery by improving effectiveness, efficiency, accessibility, safety and personalization. However, not much have been reported about their effectiveness. We aimed to evaluate the clinical effectiveness of DHI in self-management and control of diabetes and its outcomes.

METHODS: We searched PubMed database using well-defined search strategy to identify clinical studies assessing the clinical effectiveness of DHI in the management of diabetes mellitus (DM) from 2014 onwards. The registers of current and ongoing trials, and gray literature were also searched. Outcomes of interest included improvement in glycated hemoglobin (HbA1c). Observational studies, review articles, case reports/studies, and case-control studies were excluded.

RESULTS: Of the 551 studies identified from searches, 78 (14%) met the eligibility criteria. Included studies were randomized controlled trials (RCTs; n=49), non-RCTs (n=6), and systematic reviews of RCTs (n=23). RCTs/non-RCTs were from USA and Canada (n=24), Asia-Pacific (n=17), Europe (n=11), and Middle-East and Africa (n=3). 53 studies had patients with T2DM, 11 with T1DM and 14 were mixed. Three major categories that were identified across the spectrum of DHI included Mobile apps (n=57), text messages (n=13) and smart sensor devices (n=8). Most of the included studies reported HbA1c improvements, ranging from 0.2% to 1.7% over the course of 12 months in the DHI group. Beneficial effects were also observed in patients’ physical and behavioral performance, especially in medication adherence. Patients also had a 1.5% to 2.4% reduction in weight from baseline.

CONCLUSIONS: This review showed that DM specific digital Health apps improved the glycemic control by significantly reducing HbA1c levels and optimized the glycemic control in T1DM and T2DM patients. These findings support the potential use of DHI as effective approach to optimize and improve health outcomes among those living with chronic diseases through enhanced symptom control.