Effects of digital health for self-management in adult with type 2 diabetes: A systematic literature review

DOI: https://doi.org/10.56922/nmi.v1i2.394

Authors

  • Ziying Shuai Robert Gordon University, Aberdeen, UK
  • Dr. Martin Murray Robert Gordon University, Aberdeen, UK

Digital Health Services Effects And Barriers Self-Management Systematic Literature Review Type 2 Diabetes

Abstract

Background: Digital health services offer effective solutions to support self-management among adults with T2DM. These tools enable individuals to continuously collect longitudinal data on their daily behaviours and clinical datas, facilitating ongoing health assessments and timely responses to T2DM management.

Methods:  A systematic review of English peer-reviewed articles was conducted, involving a comprehensive literature search of PubMed, MEDILINE, CINAHL, Web of Science spanning from 2013 to 2023. Inclusion criteria comprised studies focusing on digital health interventions for self-management of T2DM in adults aged 18 years and above.  

Results:  Sixteen articles were identified based on the inclusion and exclusion criteria, as well as the quality evaluation standards. The review underscores the transformative potential of digital health technologies, enabling not only the monitoring and management of blood glucose levels, dietary intake, body weight control, medication adherence, and physical activities, but also facilitating personalised health information dissemination, professional education and coaching, and effective two-way communication between adults with T2DM and healthcare professionals, these features empower individuals and enhance their autonomy and engagement in managing their T2DM health.

Conclusion: This review has systematically evaluated the effectiveness and application features of digital health interventions for self-management among adults with T2DM. It identifies self-management behaviours tested in the reviewed literature and assesses the limitations of these studies. Furthermore, this review comprehensively explored the barriers, challenges, facilitators, research gaps, and future policy and practice directions associated with advanced technology-enabled self-care solutions for this population.

Keywords: Digital Health Services; Effects And Barriers; Self-Management; Systematic Literature Review; Type 2 Diabetes.

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References

Adu, M. D., Malabu, U. H., Malau-Aduli, A. E., Drovandi, A. and Malau-Aduli, B. S. (2020) 'User retention and engagement with a mobile app intervention to support self-management in Australians with type 1 or type 2 diabetes (My Care Hub): mixed methods study', JMIR mHealth and uHealth, 8(6), pp. e17802.

Anderson, R. (2007) 'Thematic content analysis (TCA)', Descriptive presentation of qualitative data, 3, pp. 1-4.

Ansari, R. M., Hosseinzadeh, H., Harris, M. and Zwar, N. (2019) 'Self-management experiences among middle-aged population of rural area of Pakistan with type 2 diabetes: a qualitative analysis', Clinical Epidemiology and Global Health, 7(2), pp. 177-183.

Aranha, M., James, K., Deasy, C. and Heavin, C. (2021) 'Exploring the barriers and facilitators which influence mHealth adoption among older adults: A literature review', Gerontechnology, 20(2).

Ashrafzadeh, S. and Hamdy, O. (2019) 'Patient-driven diabetes care of the future in the technology era', Cell metabolism, 29(3), pp. 564-575.

Barlow, J., Wright, C., Sheasby, J., Turner, A. and Hainsworth, J. (2002) 'Self-management approaches for people with chronic conditions: a review', Patient education and counseling, 48(2), pp. 177-187.

Bassi, G., Giuliano, C., Perinelli, A., Forti, S., Gabrielli, S. and Salcuni, S. (2022) 'A virtual coach (Motibot) for supporting healthy coping strategies among adults with diabetes: proof-of-concept study', JMIR Human Factors, 9(1), pp. e32211.

Carpenter, R., DiChiacchio, T. and Barker, K. (2019) 'Interventions for self-management of type 2 diabetes: an integrative review', International journal of nursing sciences, 6(1), pp. 70-91.

Cellina, M., Cè, M., Alì, M., Irmici, G., Ibba, S., Caloro, E., Fazzini, D., Oliva, G. and Papa, S. (2023) 'Digital Twins: The New Frontier for Personalized Medicine?', Applied Sciences, 13(13), pp. 7940.

Choi, W., Wang, S., Lee, Y., Oh, H. and Zheng, Z. (2020) 'A systematic review of mobile health technologies to support self-management of concurrent diabetes and hypertension', Journal of the American Medical Informatics Association, 27(6), pp. 939-945.

da Rocha, R. B., Silva, C. S. and Cardoso, V. S. (2020) 'Self-care in adults with type 2 diabetes mellitus: A systematic review', Current diabetes reviews, 16(6), pp. 598-607.

Diabetes UK (2009) Improving supported self-managementfor people with diabetes. Available at: https://www.diabetes.org.uk/resources-s3/2017-09/Supported_self-management.pdf.

Doyle, J., Murphy, E., Gavin, S., Pascale, A., Deparis, S., Tommasi, P., Smith, S., Hannigan, C., Sillevis Smitt, M. and Van Leeuwen, C. (2021) 'A digital platform to support self-management of multiple chronic conditions (ProACT): findings in relation to engagement during a one-year proof-of-concept trial', Journal of medical Internet research, 23(12), pp. e22672.

Egede, L. E., Williams, J. S., Voronca, D. C., Knapp, R. G. and Fernandes, J. K. (2017) 'Randomized controlled trial of technology-assisted case management in low-income adults with type 2 diabetes', Diabetes technology & therapeutics, 19(8), pp. 476-482.

Georgsson, M. and Staggers, N. (2017) 'Patients' perceptions and experiences of a mHealth diabetes self-management system', CIN: Computers, Informatics, Nursing, 35(3), pp. 122-130.

Greenwood, D. A., Gee, P. M., Fatkin, K. J. and Peeples, M. (2017) 'A systematic review of reviews evaluating technology-enabled diabetes self-management education and support', Journal of diabetes science and technology, 11(5), pp. 1015-1027.

Grundy, Q. (2022) 'A review of the quality and impact of mobile health apps', Annual review of public health, 43, pp. 117-134.

Hartz, J., Yingling, L. and Powell-Wiley, T. M. (2016) 'Use of mobile health technology in the prevention and management of diabetes mellitus', Current cardiology reports, 18, pp. 1-11.

Iqbal, M. P., Newman, B., Ellis, L., Mears, S. and Harrison, R. (2023) 'Characterising consumer engagement in virtual models of care: A systematic review and narrative synthesis', Patient Education and Counseling, pp. 107922.

Karlsen, B., Oftedal, B. and Bru, E. (2012) 'The relationship between clinical indicators, coping styles, perceived support and diabetes‐related distress among adults with type 2 diabetes', Journal of advanced nursing, 68(2), pp. 391-401.

Kaveh, M. H., Kaveh, S. and Faradonbeh, M. R. (2023) 'Mobile health-based interventions in self-care and treatment adherence in older people: a review study', International Journal of Aging, 1(1), pp. e6-e6.

Kebede, M. M. (2019) Augmenting Diabetes Care & Self-Management: What Can Digital Health Offer? , Universität Bremen.

Keogh, A., Brennan, C., Johnston, W., Dickson, J., Leslie, S. J., Burke, D., Megyesi, P. and Caulfield, B. (2024) 'Six-Month Pilot Testing of a Digital Health Tool to Support Effective Self-Care in People With Heart Failure: Mixed Methods Study', JMIR Formative Research, 8(1), pp. e52442.

Leonardsen, A.-C. L., Hardeland, C., Helgesen, A. K. and Grøndahl, V. A. (2020) 'Patient experiences with technology enabled care across healthcare settings-a systematic review', BMC health services research, 20, pp. 1-17.

Lewinski, A. A., Vaughn, J., Diane, A., Barnes, A., Crowley, M. J., Steinberg, D., Stevenson, J., Yang, Q., Vorderstrasse, A. A., Hatch, D., Jiang, M. and Shaw, R. J. (2021) 'Perceptions of Using Multiple Mobile Health Devices to Support Self‐Management Among Adults With Type 2 Diabetes: A Qualitative Descriptive Study', Journal of Nursing Scholarship, 53(5), pp. 643-652.

Maglalang, D. D., Yoo, G. J., Ursua, R. A., Villanueva, C., Chesla, C. A. and Bender, M. S. (2017) '"I don't have to explain, people understand": Acceptability and Cultural Relevance of a Mobile Health Lifestyle Intervention for Filipinos with Type 2 Diabetes', Ethn Dis, 27(2), pp. 143-154.

Mannoubi, C., Kairy, D., Menezes, K. V., Desroches, S., Layani, G. and Vachon, B. (2024) 'The Key Digital Tool Features of Complex Telehealth Interventions Used for Type 2 Diabetes Self-Management and Monitoring With Health Professional Involvement: Scoping Review', JMIR Medical Informatics, 12, pp. e46699.

Morton, K., Dennison, L., May, C., Murray, E., Little, P., McManus, R. J. and Yardley, L. (2017) 'Using digital interventions for self-management of chronic physical health conditions: a meta-ethnography review of published studies', Patient education and counseling, 100(4), pp. 616-635.

Muka, T., Glisic, M., Milic, J., Verhoog, S., Bohlius, J., Bramer, W., Chowdhury, R. and Franco, O. H. (2020) 'A 24-step guide on how to design, conduct, and successfully publish a systematic review and meta-analysis in medical research', European journal of epidemiology, 35, pp. 49-60.

Parmar, P., Ryu, J., Pandya, S., Sedoc, J. and Agarwal, S. (2022) 'Health-focused conversational agents in person-centered care: a review of apps', NPJ digital medicine, 5(1), pp. 21.

Pita-Barros, P., Bourek, A., Brouwer, W. and Lehtonen, L. (2019) 'Assessing the impact of digital transformation of health services. Report of the EXPH (Expert Panel on effective ways of investing in Health)'.

Rollo, M. E., Aguiar, E. J., Williams, R. L., Wynne, K., Kriss, M., Callister, R. and Collins, C. E. (2016) 'eHealth technologies to support nutrition and physical activity behaviors in diabetes self-management', Diabetes, metabolic syndrome and obesity: targets and therapy, pp. 381-390.

Schwamm, L. H. (2014) 'Telehealth: seven strategies to successfully implement disruptive technology and transform health care', Health Affairs, 33(2), pp. 200-206.

Solomon, D. H. and Rudin, R. S. (2020) 'Digital health technologies: opportunities and challenges in rheumatology', Nature Reviews Rheumatology, 16(9), pp. 525-535.

Tsai, T.-H., Lin, W.-Y., Chang, Y.-S., Chang, P.-C. and Lee, M.-Y. (2020) 'Technology anxiety and resistance to change behavioral study of a wearable cardiac warming system using an extended TAM for older adults', PloS one, 15(1), pp. e0227270.

Vaismoradi, M., Jones, J., Turunen, H. and Snelgrove, S. (2016) 'Theme development in qualitative content analysis and thematic analysis'.

Van Zyl, C., Badenhorst, M., Hanekom, S. and Heine, M. (2021) 'Unravelling ‘low-resource settings’: a systematic scoping review with qualitative content analysis', BMJ global health, 6(6), pp. e005190.

Yoon, S., Tang, H., Tan, C. M., Phang, J. K., Kwan, Y. H. and Low, L. L. (2024) 'Acceptability of Mobile App–Based Motivational Interviewing and Preferences for App Features to Support Self-Management in Patients With Type 2 Diabetes: Qualitative Study', JMIR diabetes, 9(1), pp. e48310.

Zhao, X., Wang, L., Ge, C., Zhen, X., Chen, Z., Wang, J. and Zhou, Y. (2020) 'Smartphone application training program improves smartphone usage competency and quality of life among the elderly in an elder university in China: A randomized controlled trial', International journal of medical informatics, 133, pp. 104010.

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Published

2025-07-27