Effects of mobile health interventions on health‐related outcomes in older adults with type 2 diabetes: A systematic review and meta‐analysis
Open accessAbstract
Background: Type 2 diabetes mellitus (T2DM) is a chronic metabolic condition that is associated with multiple comorbidities. Apart from pharmacological approaches, patient self‐management remains the gold standard of care for diabetes. Improving patients' self‐management among the elderly with mobile health (mHealth) interventions is critical, especially in times of the COVID‐19 pandemic. However, the extent of mHealth efficacy in managing T2DM in the older population remains unknown. Hence, the present review examined the effectiveness of mHealth interventions on cardiometabolic outcomes in older adults with T2DM. Methods: A systematic search from the inception till May 31, 2021, in the MEDLINE, Embase, and PubMed databases was conducted, and 16 randomized controlled trials were included in the analysis. Results: The results showed significant benefits on glycosylated hemoglobin (HbA1c) (mean difference −0.24%; 95% confidence interval [CI]: −0.44, −0.05; p = 0.01), postprandial blood glucose (−2.91 mmol/L; 95% CI: −4.78, −1.03; p = 0.002), and triglycerides (−0.09 mmol/L; 95% CI: −0.17, −0.02; p = 0.010), but not on low‐density lipoprotein cholesterol (−0.06 mmol/L; 95% CI: −0.14, 0.02; p = 0.170), high‐density lipoprotein cholesterol (0.05 mmol/L; 95% CI: −0.03, 0.13; p = 0.220), and blood pressure (systolic blood pressure −0.82 mm Hg; 95% CI: −4.65, 3.00; p = 0.670; diastolic blood pressure −1.71 mmHg; 95% CI: −3.71, 0.29; p = 0.090). Conclusions: Among older adults with T2DM, mHealth interventions were associated with improved cardiometabolic outcomes versus usual care. Its efficacy can be improved in the future as the current stage of mHealth development is at its infancy. Addressing barriers such as technological frustrations may help strategize approaches to further increase the uptake and efficacy of mHealth interventions among older adults with T2DM.
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A meta-analysis by Lee et al., including 16 RCTs (n=6,204) in older adults with diabetes, showed a pooled mean HbA1c decrease of -0.24% (95% CI -0.44 to -0.05).
“Similarly, the meta-analysis conducted by Lee and colleagues including 16 RCTs (participants = 6,204) and focusing on older adults with diabetes, showed several improvements in glycaemic outcomes with a pooled mean HbA1c decreased of -0.24% (95% CI -0.44 to -0.05) (33).”
From Impact of digital health on Type 2 diabetes management: a randomised controlled trial of the ‘TreC Diabete’ platform (TELEMECHRON Study) (2025) · cites this paper as [33]
mHealth interventions for older adults with T2DM improved HbA1c (MD -0.24%; 95% CI -0.44, -0.05; p = 0.01).
“Significant benefits HbA1c (MD = −0.24%; 95% CI: −0.44, −0.05; p = 0.01), postprandial BG (−2.91 mmol/L; 95% CI: −4.78, −1.03; p = 0.002), and triglycerides (−0.09 mmol/L; 95% CI: −0.17, −0.02; p = 0.010).”
From Digital diabetes management technologies for type 2 diabetes: a systematic review of home-based care interventions (2025) · cites this paper as [12]
mHealth interventions for older adults with T2DM improved postprandial blood glucose (-2.91 mmol/L; 95% CI -4.78, -1.03; p = 0.002).
“Significant benefits HbA1c (MD = −0.24%; 95% CI: −0.44, −0.05; p = 0.01), postprandial BG (−2.91 mmol/L; 95% CI: −4.78, −1.03; p = 0.002), and triglycerides (−0.09 mmol/L; 95% CI: −0.17, −0.02; p = 0.010).”
From Digital diabetes management technologies for type 2 diabetes: a systematic review of home-based care interventions (2025) · cites this paper as [12]
mHealth interventions for older adults with T2DM improved triglycerides (-0.09 mmol/L; 95% CI -0.17, -0.02; p = 0.010).
“Significant benefits HbA1c (MD = −0.24%; 95% CI: −0.44, −0.05; p = 0.01), postprandial BG (−2.91 mmol/L; 95% CI: −4.78, −1.03; p = 0.002), and triglycerides (−0.09 mmol/L; 95% CI: −0.17, −0.02; p = 0.010).”
From Digital diabetes management technologies for type 2 diabetes: a systematic review of home-based care interventions (2025) · cites this paper as [12]
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- Authors
- Lee, J. J. N., Abdul Aziz, A., Chan, S., Raja Abdul Sahrizan, R. S. F. B., Ooi, A. Y. Y., Teh, Y., Iqbal, U., Ismail, N. A., Yang, A., Yang, J., Teh, D. B. L., & Lim, L.
- Affiliations
- National University of Singapore (SG)
- Department of Medicine, Faculty of Medicine University of Malaya Kuala Lumpur Malaysia
- University of Malaya (MY)
- Tasmanian Department of Health (AU)
- Chinese University of Hong Kong (HK)
- College of Earth and Environmental Sciences Lanzhou University Lanzhou China
- Corresponding author
- Lim, Lee‐Ling
- ORCID
- Venue
- Journal of Diabetes
- Publisher
- Wiley
- Published
- 2023-01
- Volume
- 15
- Issue
- 1
- Pages
- 47-57
- ISSN
- 1753-0393 (ISSN-L)
- 1753-0407
- PMC
- PMC9870745
- OpenAlex
- W4317033114
- Cited by
- 40
- References
- 52
- Citations by year
- 2026: 14 · 2025: 13 · 2024: 10 · 2023: 2 · 2022: 1
- FWCI
- 1.97
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of Diabetes (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Greater South Information System
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- mobile health, type 2 diabetes, older adults, diabetes self-management, cardiometabolic outcomes, HbA1c, postprandial blood glucose, triglycerides, blood pressure, LDL cholesterol, HDL cholesterol, COVID-19 pandemic, digital health interventions, glycemic control, lipid profile, blood pressure control, medication adherence, physical activity, sleep quality
- MeSH terms
- COVID-19, Aged, Cardiovascular Diseases, Cholesterol, Diabetes Mellitus, Type 2, Humans, Telemedicine, Pandemics
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