National Institute for Health Innovation, University of Auckland, Auckland, New Zealand.
Institute for Innovation and Improvement, Te Whatu Ora Waitematā, Auckland, New Zealand.
PLoS One. 2024 May 10;19(5):e0303074. doi: 10.1371/journal.pone.0303074. eCollection 2024.
Rates of prediabetes, which can lead to type 2 diabetes, are increasing worldwide. Interventions for prediabetes mainly focus on lifestyle changes to diet and exercise. While these interventions are effective, they are often delivered face-to-face, which may pose a barrier to those with limited access to healthcare. Given the evidence for digital interventions addressing other noncommunicable diseases, these may also be effective for prediabetes self-management. The aim of this scoping review was to assess the breadth of evidence around digital interventions for prediabetes self-management.
We developed a targeted search strategy and relevant studies were identified through searches conducted in four bibliographic databases (Medline, Embase, PsycInfo, and Scopus). Published studies were eligible if they included a digital intervention to support adults aged 18+ with prediabetes self-management. Titles and abstracts were first screened for relevance by one researcher. Full texts of selected records were assessed against the review criteria independently by two researchers for inclusion in the final analysis.
Twenty-nine studies were included, of which nine were randomised controlled trials. Most efficacy studies reported significant changes in at least one primary and/or secondary outcome, including participants' glycaemic control, weight loss and/or physical activity levels. About one-third of studies reported mixed outcomes or early significant outcomes that were not sustained at long-term follow-up. Interventions varied in length, digital modalities, and complexity. Delivery formats included text messages, mobile apps, virtually accessible dietitians/health coaches, online peer groups, and web-based platforms. Approximately half of studies assessed participant engagement/acceptability outcomes.
Whilst the evidence here suggests that digital interventions to support prediabetes self-management are acceptable and have the potential to reduce one's risk of progression to type 2 diabetes, more research is needed to understand which interventions, and which components specifically, have the greatest reach to diverse populations, are most effective at promoting user engagement, and are most effective in the longer term.
全球范围内，前驱糖尿病（可导致 2 型糖尿病）的发病率正在上升。针对前驱糖尿病的干预措施主要侧重于饮食和运动方面的生活方式改变。虽然这些干预措施有效，但它们通常是面对面进行的，这可能会对那些难以获得医疗保健的人造成障碍。鉴于数字干预措施在其他非传染性疾病方面的证据，这些措施也可能对前驱糖尿病的自我管理有效。本范围综述的目的是评估针对前驱糖尿病自我管理的数字干预措施的证据广度。
我们制定了有针对性的搜索策略，并通过在四个书目数据库（Medline、Embase、PsycInfo 和 Scopus）中进行搜索来确定相关研究。如果研究包括支持年龄在 18 岁及以上的前驱糖尿病患者自我管理的数字干预措施，则发表的研究符合纳入标准。首先由一名研究人员筛选标题和摘要以确定相关性。然后，两名研究人员独立根据审查标准评估选定记录的全文，以确定是否纳入最终分析。
共纳入 29 项研究，其中 9 项为随机对照试验。大多数疗效研究报告称，至少有一个主要和/或次要结果发生了显著变化，包括参与者的血糖控制、体重减轻和/或体力活动水平。大约三分之一的研究报告了混合结果或早期显著结果，但在长期随访中并未持续。干预措施在长度、数字模式和复杂性方面存在差异。交付格式包括短信、移动应用程序、虚拟营养师/健康教练、在线同伴小组和基于网络的平台。大约一半的研究评估了参与者的参与/可接受性结果。
尽管这里的证据表明，支持前驱糖尿病自我管理的数字干预措施是可以接受的，并且有可能降低进展为 2 型糖尿病的风险，但需要进一步研究以了解哪些干预措施以及具体哪些组成部分对不同人群的影响最大、最能促进用户参与，以及在更长时间内最有效。
