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Mobile phone applications and self-management of diabetes: a systematic review with meta-analysis, meta-regression of 21 randomized trials, and GRADE

Research output: Contribution to journalArticlepeer-review

Can Hou, Qain Xu, Sha Diao, Jonathan Hewitt, Jiayuan Li, Benjamin Richard Carter

Original languageEnglish
JournalDIABETES OBESITY AND METABOLISM
Accepted/In press24 Mar 2018
Unpublished2020

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Abstract

We conducted a systematic review with meta-analysis of randomized controlled trials that evaluated the effect of diabetes apps. 1550 participants from 21 studies were included. For type 1 diabetes, a significant 0.49% reduction in HbA1c was seen (95%CI 0.04 to 0.94; I2=84%), with unexplained heterogeneity and a low GRADE of evidence. For type 2 diabetes, using diabetes apps was associated with a mean reduction of 0.57% (95%CI 0.32 to 0.82, I2=77%). The results had severe heterogeneity that was explained by the frequency of HCP feedback. In studies with no HCP feedback, low frequency, and high frequency the mean reduction is 0.24% (95%CI -0.02 to 0.49; I2=0%), 0.33% (95%CI 0.07 to 0.59; I2=47%), and 1.12% (95%CI 0.91 to 1.32; I2=0%) respectively, with high GRADE of evidence. There is evidence that diabetes apps improve glycemic control in type 1 diabetes patients. A reduction of 0.57% in HbA1c was found in type 2 diabetes patients. However, HCP functionality is crucial to achieve clinical effectiveness. A cost-effectiveness study is needed to evaluate whether diabetes apps should be used routinely.

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