数字健康干预对2型糖尿病患者血糖控制和身体活动的有效性：一项系统评价和荟萃分析。

The effectiveness of digital health intervention on glycemic control and physical activity in patients with type 2 diabetes: a systematic review and meta-analysis.

作者信息

Xue Haoyuan, Zhang Lin, Shi Yarong, Zhang Hao, Zhang Chuanrong, Liu Yang, Tan Wenshu, Liu Yaorong

机构信息

School of Physical Education, Xi'an Physical Education University, Xi'an, China.

Informatization Construction Office, Xi'an Physical Education University, Xi'an, China.

出版信息

Front Digit Health. 2025 Jul 29;7:1630588. doi: 10.3389/fdgth.2025.1630588. eCollection 2025.

DOI:10.3389/fdgth.2025.1630588

PMID:40799285

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12340998/

Abstract

INTRODUCTION

Digital health interventions (DHIs) offer promising strategies for managing type 2 diabetes mellitus (T2DM), yet their efficacy on physical activity remains inconsistent. This systematic review and meta-analysis evaluates DHIs' effectiveness across key clinical endpoints.

METHODS

Following PRISMA guidelines and PROSPERO registration (CRD420251032375), five databases (Web of Science, Embase, Scopus, Cochrane, PubMed) were searched through February 2025. Randomized controlled trials (RCTs) assessing DHIs (mobile applications, phone calls or SMS, online platforms, remote monitoring) versus usual care in T2DM patients were included. Primary outcomes were HbA1c, fasting blood glucose (FBG), postprandial blood glucose (PBG), HOMA-IR, and physical activity. Risk of bias was evaluated using Cochrane RoB 2. Meta-analyses employed random/fixed-effect models in Review Manager 5.3, with subgroup and sensitivity analyses for heterogeneity (² > 50%).

RESULTS

From 9,499 records, 118 RCTs (21,662 participants) were analyzed. DHIs significantly reduced HbA1c (MD = -0.32% to -0.54%), FBG (MD = -0.30 to -0.85), and PBG (SMD = -0.58) versus controls ( < 0.05). Subgroup analyses indicated online platforms most effectively lowered HbA1c (MD = -0.54). No improvements occurred in HOMA-IR (MD = -0.18, 95% CI: -0.79 to 0.44) or physical activity (SMD = 0.16, 95% CI: -0.08 to 0.39). Cost analyses revealed lower expenses in DHI groups (mean: $269.31 vs. $465.37). High heterogeneity (² = 69-92%) was observed for glycemic outcomes, partially explained by intervention duration and sample size in meta-regression.

DISCUSSION

DHIs demonstrate robust efficacy for glycemic management in T2DM, particularly through online platforms and remote monitoring. However, they fail to enhance physical activity or insulin resistance. Future studies should prioritize adaptive designs for sustained behavioral change and investigate long-term cost-effectiveness.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/PROSPERO/view/CRD420251032375, identifier (CRD420251032375).

摘要

引言

数字健康干预措施（DHIs）为管理2型糖尿病（T2DM）提供了有前景的策略，但其对身体活动的功效仍不一致。本系统评价和荟萃分析评估了DHIs在关键临床终点方面的有效性。

方法

按照PRISMA指南和PROSPERO注册要求（CRD420251032375），检索了截至2025年2月的五个数据库（科学网、Embase、Scopus、Cochrane、PubMed）。纳入了评估T2DM患者中DHIs（移动应用程序、电话或短信、在线平台、远程监测）与常规护理对比的随机对照试验（RCT）。主要结局指标为糖化血红蛋白（HbA1c）、空腹血糖（FBG）、餐后血糖（PBG）、胰岛素抵抗指数（HOMA-IR）和身体活动。使用Cochrane偏倚风险评估工具2评估偏倚风险。荟萃分析在Review Manager 5.3中采用随机/固定效应模型，并对异质性（I²>50%）进行亚组分析和敏感性分析。

结果

从9499条记录中，分析了118项RCT（21662名参与者）。与对照组相比，DHIs显著降低了HbA1c（MD=-0.32%至-0.54%）、FBG（MD=-0.30至-0.85）和PBG（SMD=-0.58）（P<0.05）。亚组分析表明，在线平台最有效地降低了HbA1c（MD=-0.54）。HOMA-IR（MD=-0.18，95%CI：-0.79至0.44）或身体活动（SMD=0.16，95%CI：-0.08至0.39）没有改善。成本分析显示，DHI组的费用较低（均值：269.31美元对465.37美元）。血糖结局观察到高异质性（I²=69-92%），在meta回归中部分由干预持续时间和样本量解释。