The Effect of Personalized Intelligent Digital Systems for Self-Care Training on Type Ii Diabetes: A Systematic Review and Meta-Analysis of Clinical Trials Publisher Pubmed



Tanhapour M¹ ; Peimani M² ; Rostam Niakan Kalhori S^{1, 3} ; Nasli Esfahani E² ; Shakibian H⁴ ; Mohammadzadeh N¹ ; Qorbani M⁵
Source: Acta Diabetologica Published:2023

Abstract

Aims: Type 2 diabetes (T2D) is rising worldwide. Self-care prevents diabetic complications. Lack of knowledge is one reason patients fail at self-care. Intelligent digital health (IDH) solutions have a promising role in training self-care behaviors based on patients’ needs. This study reviews the effects of RCTs offering individualized self-care training systems for T2D patients. Methods: PubMed, Web of Science, Scopus, Cochrane Library, and Science Direct databases were searched. The included RCTs provided data-driven, individualized self-care training advice for T2D patients. Due to the repeated studies measurements, an all-time-points meta-analysis was conducted to analyze the trends over time. The revised Cochrane risk-of-bias tool (RoB 2.0) was used for quality assessment. Results: In total, 22 trials met the inclusion criteria, and 19 studies with 3071 participants were included in the meta-analysis. IDH interventions led to a significant reduction of HbA1c level in the intervention group at short-term (in the third month: SMD = − 0.224 with 95% CI − 0.319 to − 0.129, p value < 0.0; in the sixth month: SMD = − 0.548 with 95% CI − 0.860 to − 0.237, p value < 0.05). The difference in HbA1c reduction between groups varied based on patients’ age and technological forms of IDH services delivery. The descriptive results confirmed the impact of M-Health technologies in improving HbA1c levels. Conclusions: IDH systems had significant and small effects on HbA1c reduction in T2D patients. IDH interventions’ impact needs long-term RCTs. This review will help diabetic clinicians, self-care training system developers, and researchers interested in using IDH solutions to empower T2D patients. © 2023, Springer-Verlag Italia S.r.l., part of Springer Nature.