Smartphone Applications to Prevent Type 2 Diabetes: A Systematic Review and Meta-Analysis

Esrat Jahan; Rawan Almansour; Kiran Ijaz; Shaira Baptista; Leticia Bezerra Giordan; Rimante Ronto; Sarah Zaman; Edel O'Hagan; Liliana Laranjo

doi:10.1016/j.amepre.2024.01.008

Smartphone Applications to Prevent Type 2 Diabetes: A Systematic Review and Meta-Analysis

Am J Prev Med. 2024 Jan 24:S0749-3797(24)00021-7. doi: 10.1016/j.amepre.2024.01.008. Online ahead of print.

Authors

Esrat Jahan¹, Rawan Almansour², Kiran Ijaz³, Shaira Baptista⁴, Leticia Bezerra Giordan⁵, Rimante Ronto⁶, Sarah Zaman⁷, Edel O'Hagan⁸, Liliana Laranjo⁹

Affiliations

¹ Department of Health Systems and Population, Macquarie University, Sydney, NSW, Australia; Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
² College of Applied Medical Sciences, King Faisal University, Al Ahsa, Saudi Arabia.
³ Affective Interactions lab, School of Architecture, Design and Planning, University of Sydney, Sydney, NSW, Australia.
⁴ The Australian Centre for Behavioural Research in Diabetes, Deakin University and the University of Melbourne, Melbourne, Victoria, Australia.
⁵ Northern Beaches Hospital, 105 French's Forest Rd W, French's Forest, Sydney, NSW, Australia.
⁶ Department of Health Systems and Population, Macquarie University, Sydney, NSW, Australia.
⁷ Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia.
⁸ Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
⁹ Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia. Electronic address: liliana.laranjo@sydney.edu.au.

PMID: 38272243
DOI: 10.1016/j.amepre.2024.01.008

Abstract

Introduction: Evidence supporting the use of apps for lifestyle behavior change and diabetes prevention in people at high risk of diabetes is lacking. The aim of this systematic review was to determine the acceptability and effectiveness of smartphone applications (apps) for the prevention of type 2 diabetes.

Methods: PubMed, Embase, CINAHL and PsychInfo were searched from 2008 to 2023. Included studies involved adults at high risk of developing diabetes evaluating an app intervention with the aim of preventing type 2 diabetes. Random-effects meta-analyses were conducted for weight loss, body mass index (BMI), glycated hemoglobin, and waist circumference. Narrative synthesis was conducted for all studies, including qualitative studies exploring user perspectives.

Results: Twenty-four studies (n=2,378) were included in this systematic review, including 9 randomized controlled trials (RCTs) with an average duration of 6 months, 10 quasi-experimental and 7 qualitative studies. Socially disadvantaged groups were poorly represented. Six RCTs were combined in meta-analyses. Apps were effective at promoting weight loss [mean difference (MD) -1.85; 95% CI -2.90 to -0.80] and decreasing BMI [MD -0.90, 95% CI -1.53 to -0.27], with no effect on glycated hemoglobin and waist circumference. No studies reported on diabetes incidence. Qualitative studies highlighted the need for app personalization.

Discussion: Smartphone apps have a promising effect on preventing type 2 diabetes by supporting weight loss. Future robust trials should include diverse populations in co-design and evaluation of apps and explore the role of artificial intelligence in further personalizing interventions for higher engagement and effectiveness.

Publication types

Review