A New Taxonomy for Technology-Enabled Diabetes Self-Management Interventions: Results of an Umbrella Review
Open accessAbstract
Background: A 2017 umbrella review defined the technology-enabled self-management (TES) feedback loop associated with a significant reduction in A1C. The purpose of this 2021 review was to develop a taxonomy of intervention attributes in technology-enabled interventions; review recent, high-quality systematic reviews and meta-analyses to determine if the TES framework was described and if elements contribute to improved diabetes outcomes; and to identify gaps in the literature. Methods: We identified key technology attributes needed to describe the active ingredients of TES interventions. We searched multiple databases for English language reviews published between April 2017 and April 2020, focused on PwD (population) receiving diabetes care and education (intervention) using technology-enabled self-management (comparator) in a randomized controlled trial, that impact glycemic, behavioral/psychosocial, and other diabetes self-management outcomes. AMSTAR-2 guidelines were used to assess 50 studies for methodological quality including risk of bias. Results: The TES Taxonomy was developed to standardize the description of technology-enabled interventions; and ensure research uses the taxonomy for replication and evaluation. Of the 26 included reviews, most evaluated smartphones, mobile applications, texting, internet, and telehealth. Twenty-one meta-analyses with the TES feedback loop significantly lowered A1C. Conclusions: Technology-enabled diabetes self-management interventions continue to be associated with improved clinical outcomes. The ongoing rapid adoption and engagement of technology makes it important to focus on uniform measures for behavioral/psychosocial outcomes to highlight healthy coping. Using the TES Taxonomy as a standard approach to describe technology-enabled interventions will support understanding of the impact technology has on diabetes outcomes.
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An umbrella review of technology-enabled diabetes self-management proposed a new taxonomy for digital interventions, including a distinction between synchronous and asynchronous feedback modes, but noted poor reporting on this issue in the reviewed studies.
“In an umbrella review of technology-enabled diabetes self-management [50], a new taxonomy for digital interventions was proposed. This taxonomy includes a distinction between synchronous and asynchronous feedback modes, but the authors noted poor reporting on this issue in the reviewed studies.”
From Digital Interventions for Self-Management of Type 2 Diabetes Mellitus: Systematic Literature Review and Meta-Analysis (2024) · cites this paper as [50]
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“In an umbrella review of technology-enabled diabetes self-management [50], a new taxonomy for digital interventions was proposed.”
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- Authors
- Greenwood, D. A., Litchman, M. L., Isaacs, D., Blanchette, J. E., Dickinson, J. K., Hughes, A., Colicchio, V. D., Ye, J., Yehl, K., Todd, A., & Peeples, M. M.
- Affiliations
- The University of Texas at San Antonio Health Science Center (US)
- University of Utah (US)
- Cleveland Clinic (US)
- Columbia University (US)
- T1D Exchange (US)
- Northwestern University (US)
- Association of Diabetes Care & Education Specialists, Chicago, IL, USA
- University of Central Florida (US)
- Welldoc, Columbia, MD, USA
- Corresponding author
- Greenwood, Deborah A.
- ORCID
- Venue
- Journal of Diabetes Science and Technology
- Publisher
- SAGE Publications
- Published
- 2021-08-11
- Volume
- 16
- Issue
- 4
- Pages
- 812-824
- ISSN
- 1932-2968 (ISSN-L)
- PMC
- PMC9264439
- OpenAlex
- W3193087508
- Cited by
- 31
- References
- 56
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 8 · 2023: 2 · 2022: 9 · 2021: 1
- FWCI
- 5.62
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Diabetes Science and Technology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Association of Diabetes Care and Education Specialists (None)
- 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 Management and Research
- Keywords
- diabetes self-management interventions, glycemic control, HbA1c reduction, mobile health, telemedicine, text messaging, psychosocial outcomes, behavioral effects
- MeSH terms
- Self-Management, Systematic Reviews as Topic, Diabetes Mellitus, Glycated Hemoglobin, Humans, Technology, Meta-Analysis as Topic, Text Messaging
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