Effectiveness of mobile applications in diabetic patients’ healthy lifestyles: A review of systematic reviews

      Highlights

      • Apps improve glycemic control in patients with DM in the short term.
      • Apps do not improve glycemic control in patients with DM in the long term.
      • The Apps examined focused on diet and physical exercise.
      • No significant adverse effects were identified for the users of the Apps.

      Abstract

      Objective

      (1) Examine the mobile applications that address lifestyles to improve the metabolic control of adult patients with diabetes mellitus. (2) Describe the characteristics of the used mobile applications, identify the healthy lifestyles they target, and describe any of their adverse effects.

      Methods

      Review systematic reviews. We included studies that used any mobile application to help patients improve diabetes mellitus self-management by focusing on healthy lifestyles. Studies needed to include a control group receiving regular care with no mobile devices. In May 2018, Medline, Embase, Cochrane, LILACS, PsychINFO, Cinahl and Science Direct were searched, updated in June 2021. The methodological quality of the studies was assessed by the Amstar-2 tool.

      Results

      First 804 articles were analyzed to select 17 systematic reviews, of which the methodological quality of seven was high or moderate. Interventions lasted 1−12 months. Twenty-three different mobile applications were identified that were all related to eating and physical activity. Significant changes were noted in HbA1c values. No clear improvement was observed for weight/BMI, lipid profile, quality of life or blood pressure. No adverse effects were found.

      Conclusions

      Managing the lifestyle of patients with diabetes using mobile applications improves short-term glycemic control, but the long-term results are not conclusive. The identified mobile applications focus on food and physical activity. Most are free. No adverse effects caused by using them were identified.

      PROSPERO register

      CRD42019133685

      Abbreviations:

      SERGAS (the Galician Health Service), ns (not specified), HbA1c (glycated hemoglobin), BMI (body mass index), SBP (systolic blood pressure), DBP (diastolic blood pressure), TC (total cholesterol), C-LDL (low-density lipoprotein cholesterol), C-HDL (high-desnity lipoprotein cholesterol), TG (triglycerides), APPs (mobile applications), DM (diabetes mellitus), DM1 (Type 1 diabetes mellitus), DM2 (Type 2 diabetes mellitus), eHealth (electronic health), PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses), PROSPERO (International prospective register of systematic reviews), NDLTD (Networked Digital Library of Theses and Dissertations), AMSTAR-2 (A Measurement Tool to Assess Systematic Reviews-2)

      Keywords

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