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Mobile phone apps improve blood sugar levels in people with type 2 diabetes

Hou C, Carter B, Hewitt J, et al. Do mobile phone applications improve glycemic control (HbA1c) in the self-management of diabetes? A systematic review, meta-analysis, and GRADE of 14 randomized trials Diabetes Care. 2016; 39: 2089-2095.

Review question

Do mobile phone applications (apps) improve self-management in people with diabetes?

Background

Text messages as well as computer- and web-based approaches can improve self-management in people with diabetes. Mobile phone apps that accept data and provide feedback to users have the potential to be more interactive, cheaper and more convenient than these methods. However, it is not clear how effective mobile phone apps may be for diabetes self-management.

How the review was done

This is a systematic review and meta-analysis of 14 randomized controlled trials that included 1360 participants. Key features of the studies were:

• All participants had either type 1 diabetes (4 studies) or type 2 diabetes (10 studies)
• All participants were adults (over age 18). Average age of participants with type 2 diabetes ranged from 51-62 years.
• Participants used some type of mobile phone app to enter data (eg. blood glucose levels, food intake, physical activity) and received personalized feedback on this data.
• Studies differed in the length of time people had been living with diabetes (5-13 years for people with type 2 diabetes), the app types and functions, and how long participants used the apps (3-12 months).
• Researchers measured changes in participant’s blood sugar (HbA1c) levels while using the apps.
• Results were compared to control groups who received the usual diabetes care (no telehealth options)

What the researchers found

People with type 2 diabetes who used diabetes self-management apps reported a significant decrease in blood sugar (HbA1c) levels compared to people not using the apps. This was true across all 10 studies of people with type 2 diabetes, including nine different types of apps. There is some evidence that apps enhanced with feedback from a healthcare professional provide are more effective, and younger people (< age 55) may be more likely to benefit. No conclusions can be made about the effects for people with type 1 diabetes since the quality of evidence from these studies was very low.

Conclusion

Mobile phone apps for diabetes self-management help improve blood sugar levels in people with type 2 diabetes. The convenience, availability and low cost of such apps mean they are a good choice to add to standard diabetes self-management approaches.