Medicine with Specialization in Internal Medicine and General Medicine, Hochschule Fulda-University of Applied Sciences, Fulda, Germany.
JMIR Mhealth Uhealth. 2021 Feb 15;9(2):e23477. doi: 10.2196/23477.
According to the World Health Organization, the worldwide prevalence of diabetes mellitus (DM) is increasing dramatically and DM comprises a large part of the global burden of disease. At the same time, the ongoing digitalization that is occurring in society today offers novel possibilities to deal with this challenge, such as the creation of mobile health (mHealth) apps. However, while a great variety of DM-specific mHealth apps exist, the evidence in terms of their clinical effectiveness is still limited.
The objective of this review was to evaluate the clinical effectiveness of mHealth apps in DM management by analyzing health-related outcomes in patients diagnosed with type 1 DM (T1DM), type 2 DM (T2DM), and gestational DM.
A scoping review was performed. A systematic literature search was conducted in MEDLINE (PubMed), Cochrane Library, EMBASE, CINAHL, and Web of Science Core Collection databases for studies published between January 2008 and October 2020. The studies were categorized by outcomes and type of DM. In addition, we carried out a meta-analysis to determine the impact of DM-specific mHealth apps on the management of glycated hemoglobin (HbA).
In total, 27 studies comprising 2887 patients were included. We analyzed 19 randomized controlled trials, 1 randomized crossover trial, 1 exploratory study, 1 observational study, and 5 pre-post design studies. Overall, there was a clear improvement in HbA values in patients diagnosed with T1DM and T2DM. In addition, positive tendencies toward improved self-care and self-efficacy as a result of mHealth app use were found. The meta-analysis revealed an effect size, compared with usual care, of a mean difference of -0.54% (95% CI -0.8 to -0.28) for T2DM and -0.63% (95% CI -0.93 to -0.32) for T1DM.
DM-specific mHealth apps improved the glycemic control by significantly reducing HbA values in patients with T1DM and T2DM patients. In general, mHealth apps effectively enhanced DM management. However, further research in terms of clinical effectiveness needs to be done in greater detail.
根据世界卫生组织的数据，全球糖尿病（DM）的患病率正在急剧上升，DM 是全球疾病负担的重要组成部分。与此同时，当今社会正在进行的数字化为应对这一挑战提供了新的可能性，例如创建移动健康（mHealth）应用程序。然而，尽管存在各种针对 DM 的 mHealth 应用程序，但就其临床效果而言，证据仍然有限。
本综述旨在通过分析 1 型糖尿病（T1DM）、2 型糖尿病（T2DM）和妊娠期糖尿病患者的健康相关结局，评估 mHealth 应用程序在 DM 管理中的临床效果。
进行了范围界定审查。对 MEDLINE（PubMed）、Cochrane 图书馆、EMBASE、CINAHL 和 Web of Science 核心合集数据库进行了系统文献检索，以检索 2008 年 1 月至 2020 年 10 月期间发表的研究。根据结局和 DM 类型对研究进行分类。此外，我们进行了一项荟萃分析，以确定针对 DM 的 mHealth 应用程序对糖化血红蛋白（HbA）管理的影响。
共有 27 项研究，包括 2887 名患者被纳入研究。我们分析了 19 项随机对照试验、1 项随机交叉试验、1 项探索性研究、1 项观察性研究和 5 项前后设计研究。总体而言，T1DM 和 T2DM 患者的 HbA 值明显改善。此外，还发现 mHealth 应用程序使用后自我护理和自我效能感有积极改善的趋势。荟萃分析显示，与常规护理相比，T2DM 的平均差异为-0.54%（95%CI-0.8 至-0.28），T1DM 的平均差异为-0.63%（95%CI-0.93 至-0.32）。
针对 DM 的 mHealth 应用程序通过显著降低 T1DM 和 T2DM 患者的 HbA 值改善了血糖控制。总体而言，mHealth 应用程序有效地增强了 DM 管理。然而，需要更详细地开展关于临床效果的进一步研究。
