Fredensborg Holm Tanja, Udsen Flemming Witt, Giese Iben Engelbrecht, Færch Kristine, Jensen Morten Hasselstrøm, von Scholten Bernt Johan, Hangaard Stine
Department of Health Science and Technology, Aalborg University, Gistrup, Denmark.
Steno Diabetes Center North Jutland, Aalborg University Hospital, Aalborg, Denmark.
J Diabetes Sci Technol. 2024 Nov 7:19322968241292646. doi: 10.1177/19322968241292646.
Digital health lifestyle interventions (DHLI) may offer scalable solutions to manage prediabetes in clinical practice; however, their effectiveness on people with prediabetes has not been systematically investigated and reviewed. Hence, in this systematic review, meta-analysis, and meta-regression the effectiveness of DHLI on prediabetes-related outcomes was investigated.
Four databases were searched to identify randomized controlled trials investigating the effectiveness of DHLI on adults with prediabetes published before 23 February 2024. The primary outcome was the change in body weight, with secondary outcomes including, among others, glycemic status, body composition, and feasibility outcomes. Meta-analyses were conducted to provide overall effect estimates of outcomes. In addition, meta-regressions on the primary outcome were conducted. The study quality was assessed using the Cochrane Risk of Bias tool, and the certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.
A total of 33 studies were included (n = 14 398). The study duration ranged from 3 to 60 months. The digital interventions varied from in-person meetings combined with pedometers and telephone calls to fully digital interventions. The overall estimated treatment difference in change in body weight favored the intervention (mean difference: -1.74 kg; 95% confidence interval: -2.37, -1.11; .01) with moderate certainty. Statistically significant overall effect estimates favoring the intervention were also found for secondary outcomes with very low to moderate certainty.
Digital health lifestyle interventions can result in statistically significant change in body weight and other secondary outcomes among people with prediabetes.
数字健康生活方式干预（DHLI）可能为临床实践中管理糖尿病前期提供可扩展的解决方案；然而，其对糖尿病前期患者的有效性尚未得到系统的研究和综述。因此，在本系统评价、荟萃分析和荟萃回归中，研究了DHLI对糖尿病前期相关结局的有效性。
检索四个数据库，以确定在2024年2月23日前发表的关于DHLI对糖尿病前期成年人有效性的随机对照试验。主要结局是体重变化，次要结局包括血糖状态、身体成分和可行性结局等。进行荟萃分析以提供结局的总体效应估计。此外，对主要结局进行了荟萃回归。使用Cochrane偏倚风险工具评估研究质量，并使用推荐分级评估、制定和评价（GRADE）方法评估证据的确定性。
共纳入33项研究（n = 14398）。研究持续时间为3至60个月。数字干预措施从面对面会议结合计步器和电话到完全数字化干预不等。体重变化的总体估计治疗差异有利于干预组（平均差异：-1.74 kg；95%置信区间：-2.37，-1.11；P <.01），确定性为中等。对于次要结局，也发现了有利于干预组的具有极低至中等确定性的统计学显著总体效应估计。
数字健康生活方式干预可使糖尿病前期患者的体重和其他次要结局产生统计学显著变化。
