Digital Health Interventions to Prevent Type 2 Diabetes Mellitus: Systematic Review

May combine two claims.

Of 12 DCP studies assessing dysglycemia, 9 (75%) reported positive population health outcomes and 3 (25%) showed neutral effects.

“Of the 12 studies (92.3%) assessing the effects of dysglycemia, 9 (75%) reported positive population health outcomes, such as significant HbA1c reduction compared to the control group in Kim et al [45] using virtual reality (VR) technology and Everett et al [46] using AI interventions (P<.05). Furthermore, 3 (25%) studies [40,44,47] showed the effect was neutral.”

• cites [45] sourceSupported
• cites [46] sourcePartly supported

  The Results (Effectiveness and Safety; page unavailable) report a significant A1c reduction of 0.1% (P=.04) in the intervention cohort, and the Introduction (Study Intervention; page unavailable) identifies Sweetch as AI-based. But the Methods (Statistical Analysis; page unavailable) compare participants’ measurements before and after the intervention, not against a control group. Everett et al. also do not report the citing review’s totals of 9 positive and 3 neutral studies. (LLM, conf=0.90)

  Experimental — accuracy not yet measured
• cites [40] sourceSupported
• cites [44] sourceSupported
• cites [47] sourceDisputed

  The Results (Primary Outcomes; page unavailable) report no significant effect on fasting plasma glucose, but a significant HbA1c reduction in the TCM app group compared with controls. Thus, this paper does not support classifying its dysglycemia findings as neutral. As a single trial, it also cannot establish the citing review’s counts of 9 positive and 3 neutral studies. (LLM, conf=0.88)

  Checked by a reasoning model — may be wrong.

  Experimental — accuracy not yet measured

May combine two claims.

TM effects on consumer experience were varied: 5 (71.4%) studies reported positive effects, 1 (14.2%) no discernible effect, and 1 (14.2%) mixed effects.

“The effects of TM on consumer experience were varied, with 5 (71.4%) studies [39,44,48,53,54] reporting positive effects, 1 (14.2%) study [5] with no discernible effect, and 1 (14.2%) study [55] with mixed effects.”

• cites [39] sourceCould not verify

  Citation [5] is attached to the claim that this study found no discernible effect on consumer experience, not to the seven-study tally. The Results (‘Adherence and satisfaction’; page unavailable) report participant satisfaction scores across three support centres, but do not report an intervention-versus-control effect on consumer experience. The Results (‘Primary outcomes’; page unavailable) report no overall effect on diabetes incidence, which is a different outcome. (LLM, conf=0.72)

  Experimental — accuracy not yet measured
• cites [44] sourceDisputed

  The Results section on process measures reports high user ratings of the app (4.3 out of 5), and the Discussion says users accepted it and deemed it effective. The paper’s lack of a significant intervention effect concerns its primary clinical outcome, not a lack of discernible positive consumer experience. (LLM, conf=0.82)

  Checked by a reasoning model — may be wrong.

  Experimental — accuracy not yet measured
• cites [48] sourceSupported
• cites [53] sourceDisputed

  The citation [5] is attached to the claim that one study found no discernible effect on consumer experience. In Results > Psychosocial Factors (page unavailable), this study instead reports significantly greater exercise enjoyment for exercise-videogame participants than controls. The reported lack of difference in enjoyment was between standard exercise and controls, not between the videogame group and controls. (LLM, conf=0.82)

  Checked by a reasoning model — may be wrong.

  Experimental — accuracy not yet measured
• cites [54] sourceCould not verify

  The available copy identifies IGT Care Call as a telephone service, but its retrieved passages contain bibliographic information rather than findings about consumer experience. Searches for patient satisfaction, service-user experience, and an absence of discernible effect found no passage that could verify the result attributed to this study. The five-study and one-study counts are the citing authors’ synthesis, not a finding attributed to this individual source. (LLM, conf=0.72)

  Experimental — accuracy not yet measured
• cites [5] sourcePartly supported

  The Results section, “Process Measures and Other Behaviors” (page unavailable), reports high participation and significant improvements in self-confidence and other self-reported outcomes, supporting a positive finding for this intervention. It does not assess consumer experience directly or establish the citing paper’s seven-study breakdown; those counts are the citing authors’ synthesis. (LLM, conf=0.73)

  Experimental — accuracy not yet measured
• cites [55] sourceNot checked — no full text of the source

May combine two claims.

Of 5 TM studies on T2DM development, 1 by Sakane et al indicated TM is effective, and the other 4 did not show significant differences compared to the control group.

“Of the 5 (20%) studies reporting the effects of TM on T2DM development, only 1 (20%) study by Sakane et al [39] indicated that TM is effective. The other 4 (80%) studies [35,40,44,50] did not show any significant differences compared to the control group.”

• cites [39] sourceDisputed

  The Results (Primary outcomes; page unavailable) report no reduction in T2DM development overall: HR 1.00 (95% CI 0.74–1.34). The Discussion (Main findings; page unavailable) explicitly says the study could not prove the intervention effective overall. A significant reduction appeared only in the subgroup at the centre providing 10 telephone calls, so describing the study without that qualification as showing TM was effective contradicts its overall finding. (LLM, conf=0.88)

  Checked by a reasoning model — may be wrong.

  Experimental — accuracy not yet measured
• cites [35] sourceSupported
• cites [40] sourceSupported
• cites [44] sourceSupported
• cites [50] sourcePartly supported

  The Exploratory Outcomes section reports no statistically significant difference between intervention and usual care for *combined prediabetes or diabetes* incidence (hazard ratio 0.90, 95% CI 0.78–1.04). It does not report a separate significance test for type 2 diabetes development, so it supports the cited sentence only at the broader combined-outcome level. The paper does not assess the sentence’s count of five studies or its claim about Sakane et al. (LLM, conf=0.85)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

This systematic review was conducted and reported following PRISMA 2020 guidelines.

“This systematic review was conducted and reported following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines of 2020 [27].”

• cites [27] sourcePartly supported

  The Abstract identifies PRISMA 2020 as a guideline for reporting systematic reviews, supporting the citation’s identification of the reporting guideline. The Scope of the guideline section explicitly says it is not intended to guide systematic review conduct, so the claim that the review was conducted following PRISMA 2020 is not supported by this source. (LLM, conf=0.90)

  Experimental — accuracy not yet measured

Classified as probably not a substantial claim. May combine two claims.

Risk of bias was assessed using RoB 2 for randomized trials and ROBINS-I for nonrandomized studies by three reviewers.

“The Cochrane risk-of-bias version 2 tool (RoB 2) for randomized trials was used to assess the quality of RCTs [32], while the ROBINS-I (risk of bias in nonrandomized studies of interventions) tool was applied for nonrandomized studies [33] by TD, QO, and LJ.”

• cites [32] sourceSupported
• cites [33] sourceSupported

May combine two claims.

Castro Sweet et al used PPC, TCP, and PHT; after the interventions, the mean HbA1c of participants reduced by 0.1% (P=.001).

“For example, Castro Sweet et al [10] used PPC, TCP, and PHT in their DHIs; after the interventions, the change in the mean HbA1c of participants reduced by 0.1% (P=.001).”

• cites [10] sourcePartly supported

  The Method > Intervention section describes personalized health coaching, phone contact, and digital tracking tools, broadly consistent with the intervention description, though it does not use the acronyms PPC, TCP, or PHT. Results > Biometrics reports a mean HbA1c decrease of 0.14% in the 69 participants with available results, but gives P=.0001, not P=.001; the HbA1c result does not cover all participants. (LLM, conf=0.90)

  Experimental — accuracy not yet measured

May combine two claims.

Kim et al using virtual reality and Everett et al using AI interventions showed significant HbA1c reduction compared to the control group (P<.05).

“such as significant HbA1c reduction compared to the control group in Kim et al [45] using virtual reality (VR) technology and Everett et al [46] using AI interventions (P<.05).”

• cites [45] sourceSupported
• cites [46] sourcePartly supported

  The Results (Effectiveness and Safety) report a significant A1c reduction of 0.1% in the Sweetch intervention cohort (P=.04), and the Discussion (Significance of Findings) identifies the intervention as using machine learning. But the Methods (Statistical Analysis) describe a comparison with the cohort’s own baseline, not a control group; the paper therefore does not support the claimed between-group reduction. (LLM, conf=0.91)

  Experimental — accuracy not yet measured

May combine two claims.

Of 5 PHT studies on T2DM prevention, 1 (20%) posted a positive effect and 4 (80%) reported a neutral effect.

“Of the 5 (13.5%) studies on PHT reporting its effects on preventing T2DM, 1 (20%) study [39] posted a positive effect, with 4 (80%) other studies [35,36,40,41] reporting a neutral effect on T2DM development.”

• cites [39] sourceSupported
• cites [35] sourceSupported
• cites [36] sourcePartly supported

  The Results (section 3.2) report a 3% cumulative incidence of type 2 diabetes at two years and a 52.3% incidence of normoglycemia, supporting a promising prevention finding. But this was a single-arm pilot study; the Discussion says it was not designed to establish superiority over other interventions and calls for further research on diabetes prevention. It therefore does not establish the positive effect on T2DM development implied by the citing sentence. The counts and percentages of studies are the citing authors’ classification, not a finding attributed to this paper. (LLM, conf=0.86)

  Experimental — accuracy not yet measured
• cites [40] sourceSupported
• cites [41] sourceSupported

May combine two claims.

Only 1 (14.2%) study assessed HCP experience in TM interventions, with HCP participants leaving positive feedback for TM, according to Savas et al.

“Only 1 (14.2%) study assessed HCP experience in TM interventions, with HCP participants leaving positive feedback for TM, according to Savas et al [54].”

• cites [54] sourceCould not verify

  The available passages from the indexed copy are bibliographic metadata identifying a telephone-based service, not findings about healthcare professionals. Searches for HCP experience and positive feedback returned no relevant passage, so the attributed feedback cannot be verified from our copy. The 1 (14.2%) figure describes the citing document's set of studies, not a finding expected from Savas et al. (LLM, conf=0.73)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

Participants from Block et al reported both positive and negative feedback.

“For example, participants from Block et al [5] reported both positive and negative feedback.”

• cites [5] sourcePartly supported

  The Discussion’s “Features Promoting Effectiveness” section (page unavailable) says some people appreciate the team feature while others dislike it, supporting the idea of mixed reactions. It does not say that participants reported positive and negative feedback, so the claim overstates what the paper documents. (LLM, conf=0.80)

  Experimental — accuracy not yet measured

May combine two claims.

Two DCP studies reported prevention effectiveness, and both had a neutral effect.

“In addition, 2 (15.4%) studies [40,44] reported prevention effectiveness of DCP, and both had a neutral effect.”

• cites [40] sourcePartly supported

  The Results report no significant between-group differences in impaired glucose tolerance or type 2 diabetes at 12 months, which supports describing the observed diabetes-related effect as neutral. But the Discussion says a larger, longer study is needed to determine whether the program prevents progression to type 2 diabetes; this trial was powered for postpartum weight retention, not prevention effectiveness. (LLM, conf=0.82)

  Experimental — accuracy not yet measured
• cites [44] sourceSupported

May combine two claims.

Of 16 PPC studies, 2 reviewing T2DM prevention showed a neutral effect, with no significant difference in T2DM diagnosis compared to the control group.

“Of 16 (30.2%) studies, 2 (12.5%) studies reviewing the effects of PPC on T2DM prevention were by Fitzpatrick et al [35] and McKenzie et al [36]. Results showed a neutral effect, with no significant difference in the T2DM diagnosis compared to the control group.”

• cites [35] sourceSupported
• cites [36] sourcePartly supported

  The Results (section 3.3) say that type 2 diabetes prevalence was unchanged from baseline after correction for multiple comparisons. But the Methods (section 2.1) describe a single-arm study, so McKenzie et al. did not find a nonsignificant difference in diagnoses compared with a control group. (LLM, conf=0.88)

  Experimental — accuracy not yet measured

May combine two claims.

One study applied PHR and HCP DS; Mann et al reported no change in HbA1c and blood glucose levels after the intervention.

“One study applied PHR and HCP DS in their DHIs. Mann et al [49] reported no change in HbA1c and blood glucose levels after the intervention.”

• cites [49] sourcePartly supported

  The Discussion (page unavailable) explicitly reports a lack of change in A1C, and the Abstract reports no change in glycemic control. The Methods list A1C, but not a separate blood-glucose measurement; they describe EMR tools used by primary care providers rather than a patient health record (PHR). (LLM, conf=0.87)

  Experimental — accuracy not yet measured

May combine two claims.

Of 3 DCP studies on consumer experience, Cha et al and Potzel et al reported better experience outcomes for patients in the DHI groups, while Block et al showed no effect.

“Of the 3 (23.1%) studies reporting the effectiveness of DCP on consumer experience, Cha et al [48] and Potzel et al [44] reported better experience outcomes for patients in the DHI groups, while Block et al [5] showed no effect.”

• cites [48] sourcePartly supported

  The Results section on participant satisfaction (page unavailable) reports that participants rated the digital-platform intervention 4.15 out of 5 and described positive aspects of their experience. However, the Method > Study design section describes a one-group pretest–posttest study, so it cannot establish better consumer experience in a DHI group relative to another group. (LLM, conf=0.88)

  Experimental — accuracy not yet measured
• cites [44] sourcePartly supported

  The Results (Per-protocol group; page unavailable) report higher well-being and lower perceived stress than in controls among regular app users, but these differences were not statistically significant. The Results (Process measures of the intervention; page unavailable) also report favorable app ratings from users, without a control-group comparison. Thus the paper supports favorable experience findings, but not a clear improvement across the intervention group. (LLM, conf=0.83)

  Experimental — accuracy not yet measured
• cites [5] sourceCould not verify

  The Results sections report clinical outcomes and program participation, but no comparison of consumer-experience outcomes between groups. I searched for patient experience, satisfaction, acceptability, and quality of life; the copy does not establish the attributed finding of no effect on consumer experience. (LLM, conf=0.76)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

Gentili et al indicated that several types of DHIs, such as videoconferencing systems, messaging, calls, mobile apps, and web-based platforms, help reduce health care costs.

“They indicated that several types of DHIs, such as videoconferencing systems, messaging, calls, mobile apps, and web-based platforms, help reduce health care costs.”

• cites [101] sourcePartly supported

  The Discussion reports cost savings for studies of videoconferencing, text messaging, web platforms, and mobile applications. But the Telephone support section says calls produced similar or slightly higher costs, not savings; the Text messaging intervention section reports savings in only one of five studies. The claim overgeneralizes the cost-reduction finding to all the listed types. (LLM, conf=0.90)

  Experimental — accuracy not yet measured

May combine two claims.

Habit formation usually takes 2-3 months, and significant HbA1c changes require at least 3 months.

“This can be because habit formation usually takes 2-3 months [86], and significant HbA1c changes require at least 3 months [87].”

• cites [86] sourceSupported
• cites [87] sourcePartly supported

  The citation [87] applies only to the HbA1c clause, not the separate habit-formation claim [86]. The Correlation Between BGM and A1C section discusses A1C as a measure of average glucose, and Table 6.1 describes glucose readings collected over three months per A1C measurement. Neither establishes that a significant HbA1c change requires at least three months; that minimum is unsupported. (LLM, conf=0.83)

  Experimental — accuracy not yet measured

May combine two claims.

All studies successful in improving dysglycemia had a DHI duration of at least 3 months, while the study successful in T2DM prevention had a duration of 12 months.

“All studies successful in improving dysglycemia had a DHI duration of at least 3 months, while the study successful in T2DM prevention had a duration of 12 months [39].”

• cites [39] sourcePartly supported

  The Methods (Intervention arm; page unavailable) describe telephone support over one year, and the Results (Primary outcomes; page unavailable) report significantly lower T2DM incidence for the high-frequency centre C subgroup. The trial found no overall reduction in T2DM incidence, however, so calling the study successful without that qualification overstates its findings. This single trial also does not establish that all studies improving dysglycemia lasted at least three months. (LLM, conf=0.88)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

According to Gentili et al, there is convincing evidence of the cost-effectiveness of DHI in health care.

“According to a systematic review of DHIs by Gentili et al [101], there is convincing evidence of the cost-effectiveness of DHI in health care.”

• cites [101] sourcePartly supported

  The Conclusion reports some evidence of favorable cost and health outcomes, but calls the overall evidence for cost-effectiveness in health care “scarce and limited.” It also says methodological heterogeneity makes comparisons difficult. “Convincing evidence” overstates the review’s conclusion. Page numbers were not provided in our copy. (LLM, conf=0.88)

  Experimental — accuracy not yet measured

May combine two claims.

Many studies showed that PHT successfully increases physical activity and decreases a sedentary lifestyle.

“Similarly, many studies showed that PHT successfully increases physical activity and decreases a sedentary lifestyle [91-93].”

• cites [91] sourceSupported
• cites [92] sourceNot checked — no full text of the source
• cites [93] Finkelstein, J, 2015, Stud Health Technol InformNot matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Lampickienė et al concluded that HCPs mostly report positive experiences with digital consultations, which have advantages for HCPs and patients.

“Lampickienė et al [100] concluded that HCPs mostly report positive experiences with digital consultations, which have advantages for HCPs and patients.”

• cites [100] sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

The only study reporting HCP experience indicated a positive effect.

“The only study reporting HCP experience indicated a positive effect.”

Probably not a substantial claim: may not pass S3 (load-bearing).

DHIs were mostly applied in combination with HCP interactions (n=43, 81.1%).

“DHIs were mostly applied in combination with HCP interactions (n=43, 81.1%).”

May combine two claims.

For the T2DM development outcome, DHI effects were positive in 1 study, neutral in 9 studies, and there were insufficient data in 4 studies.

“For the T2DM development outcome, the effects of DHIs were positive in 1 (7.1%) study and neutral in 9 (64.3%) studies, and there were insufficient data to assess in 4 (28.6%) studies.”

• Also stated in: § Results · plain

  “For the T2DM development outcome, the effects of DHIs were positive in 1 (1.9%) study and neutral in 9 (17%) studies, and there were insufficient data to assess in 4 (7.5%) studies.”

May combine two claims.

Five outcomes were reported: consumer experience (n=13, 24.5%), health care costs (n=3, 5.7%), HCP experience (n=1, 1.9%), development of T2DM (n=14, 26.4%), and dysglycemia changes (n=52, 98.1%).

“Five outcomes were reported: consumer experience (n=13, 24.5%), health care costs (n=3, 5.7%), HCP experience (n=1, 1.9%), development of T2DM (n=14, 26.4%), and dysglycemia changes (n=52, 98.1%).”

Probably not a substantial claim: may not pass S3 (load-bearing).

In total, 15 DHIs were investigated.

“In total, 15 DHIs were investigated.”

May combine two claims.

The effects of DHIs on consumer experience were mixed, with most being positive (n=7, 53.8%).

“The effects of DHIs in all studies on consumer experience were mixed, with most being positive (n=7, 53.8%).”

May combine two claims.

Approximately 12 of 22 (54.5%) randomized controlled trials for HbA1c change and 10 of 23 (43.5%) for blood glucose change had some concerns or high risk of bias.

“the risks of bias in HbA1c and blood glucose change outcomes exhibited some similarities, with approximately 12 of 22 (54.5%) and 10 of 23 (43.5%) studies, respectively, presenting either some concerns or high risks.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The HCP experience outcome was not assessed in randomized controlled trials.

“The HCP experience outcome was not assessed in RCTs.”

May combine two claims.

For the dysglycemia outcome, DHI effects were positive in 23 (43.4%) studies, neutral in 24 (45.3%) studies, and there were insufficient data in 6 (11.3%) studies.

“For the dysglycemia outcome, the effects were positive in 23 (43.4%) studies and neutral in 24 (45.3%) studies, and there were insufficient data in 6 (11.3%) studies.”

• Also stated in: § Study Interventions · plain

  “For the dysglycemia outcome, the effects were positive in 23 (43.4%) studies and neutral in 24 (45.3%) studies, and there were insufficient data in 6 (11.3%) studies.”

Probably not a substantial claim: may not pass S3 (load-bearing).

All included studies had a duration of at least 3 months.

“All studies had a duration of at least 3 months.”

May combine two claims.

Among 10 (18.9%) studies with a low risk of bias in all outcomes and an intervention duration of at least 1 year, none assessed T2DM development; dysglycemia effects were positive in 7 (70%), neutral in 2 (20%), and insufficient in 1 (10%).

“Among the 10 (18.9%) studies with a low risk of bias in all outcomes and an intervention duration of at least 1 year, none assessed the development of T2DM; the effects of DHIs on dysglycemia were positive in 7 (70%) studies and neutral in 2 (20%) studies, and there were insufficient data in 1 (10%) study.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Randomized controlled trials were the most common research design (n=31, 58.5%).

“RCTs were the most common research design (n=31, 58.5%).”

May combine two claims.

Most included studies were conducted in health care settings (n=35, 66%) and in high-income countries (n=49, 92.5%).

“Most studies were conducted in health care settings (n=35, 66%) and in high-income countries (n=49, 92.5%) [84].”

• cites [84] World Bank country and lending groupsWorld Bank20242025-04-17https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groupsNot matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

May combine two claims.

There were no high risks of bias in consumer experience and health care cost outcomes, with the majority having low risks (n=37, 70%, and n=35, 66.7%, respectively).

“There were no high risks of bias in consumer experience and health care cost outcomes, with the majority having low risks (n=37, 70%, and n=35, 66.7%, respectively).”

May combine two claims.

In total, 3373 citations were retrieved, 53 (1.6%) met the inclusion criteria, encompassing 34,488 participants.

“In total, 3373 citations were retrieved from the database search, of which 53 (1.6%) met the inclusion criteria, encompassing a total of 34,488 participants.”

May combine two claims.

There were 24 (45.3%) studies with a low risk of bias in all outcomes and 10 (41.7%) studies with both a low risk of bias and an intervention duration of at least 1 year.

“There were 24 (45.3%) studies with a low risk of bias in all outcomes and 10 (41.7%) studies with both a low risk of bias and an intervention duration of at least 1 year.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The DHI duration ranged from 1 to 48 months.

“The DHI duration fluctuated from 1 to 48 months.”

Probably not a substantial claim: may not pass S3 (load-bearing).

No studies reported the effects of on-demand communication on HCP experience.

“No studies reported the effects of on-demand communication on HCP experience.”

May combine two claims.

Of 47 studies assessing TCP effects on dysglycemia changes, 24 (51.1%) reported neutral and 23 (48.9%) positive effects.

“Of the 47 (88.7%) studies assessing dysglycemia changes, 24 (51.1%) reported neutral effects, and 23 (48.9%) posted positive effects.”

May combine two claims.

Of 15 PPC studies assessing dysglycemia, 10 (66.7%) posted positive effects and 5 (33.3%) showed no discernible effect.

“Of the 15 (93.8%) PPC studies assessing dysglycemia changes, 10 (66.7%) posted positive effects and 5 (33.3%) showed no discernible effect.”

May combine two claims.

Of 20 TM studies assessing glycemia, 11 (55%) showed that TM improves HbA1c or blood glucose significantly and 9 (45%) reported neutral effects.

“Of the 20 (80%) studies assessing changes in the glycemia status of participants, 11 (55%) showed that TM improves HbA1c or blood glucose significantly and 9 (45%) reported neutral effects.”

May combine two claims.

In 37 (69.8%) studies, PHT allowed individuals to self-monitor their health or diagnostic data (n=28, 75.7%) or actively capture/store health data to the digital platform (n=15, 40.5%).

“In 37 (69.8%) studies, PHT allowed individuals to self-monitor their health or diagnostic data (n=28, 75.7%) or actively capture/store health data to the digital platform (n=15, 40.5%).”

May combine two claims.

Of 37 PHT studies, 34 (91.9%) assessed dysglycemia changes, with positive (61.8%) and neutral (38.2%) effects.

“Of the 37 (69.8%) studies, 34 (91.9%) assessed the effectiveness of PHT in dysglycemia changes, with both positive (61.8%) and neutral (38.2%) effects.”

May combine two claims.

Of 10 studies reviewing TCP effects on T2DM prevention, 9 (90%) were neutral and 1 (10%) was positive.

“Of the 10 (18.9%) studies reviewing the effects of TCP on T2DM prevention, 9 (90%) were neutral, and 1 (10%) was positive.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Effects of PHR and HCP DS on T2DM prevention, consumer experience, HCP experience, and health care costs were not included in the study.

“Effects on T2DM prevention, consumer experience, HCP experience, and health care costs were not included in the study.”

May combine two claims.

TCP effects on consumer experience were mixed, on HCP experience positive, and on health care cost neutral (n=1, 33.3%) or negative (n=2, 66.7%).

“The effects of TCP on consumer experience was mixed, on HCP experience was positive, and on health care cost was neutral (n=1, 33.3%) or negative (n=2, 66.7%).”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

TM included remote consultations (n=25, 47.2%) and remote health monitoring (n=7, 13.2%).

“TM included remote consultations (n=25, 47.2%) and remote health monitoring (n=7, 13.2%).”

May combine two claims.

Of 10 PHT studies on consumer experience, 4 (40%) showed a positive effect, 3 (30%) negative, 2 (20%) neutral, and 1 (10%) mixed.

“Of the 10 (27%) studies assessing the effects of PHT on consumer experience, the results varied; 4 (40%) studies showed a positive effect, 3 (30%) showed a negative effect, 2 (20%) were inconclusive or neutral, and 1 (10%) showed mixed effects.”

May combine two claims.

There are insufficient studies on HCP experience and health care costs.

“The effects of DHIs on T2DM prevention, as measured by the quadruple aims, have not been comprehensively assessed, with proven benefits for population health, mixed results for consumer experience, and insufficient studies on HCP experience and health care costs.”

May combine two claims.

Health records and HCP DS were the least common in this review, with only 1 included study showing neutral effects.

“Health records and HCP DS were the least common in our review, with only 1 included study showing neutral effects.”

May combine two claims.

Automatic data capture in wearables and medical devices received more positive feedback than manual data capture, which had only neutral or negative effects.

“Automatic data capture in wearables and medical devices received more positive feedback than manual data capture, which had only neutral or negative effects.”

May combine two claims.

There were insufficient studies assessing HCP experience (1 study) and health care costs (3 studies).

“Finally, there were insufficient studies assessing HCP experience (1 study) and health care costs (3 studies).”

May combine two claims.

Among successful studies, the one that reported delaying the development of T2DM and 16 (69.6%) of those reporting improvements in dysglycemia involved HCP interaction.

“Among these successful studies, the one that reported delaying the development of T2DM and 16 (69.6%) of those reporting improvements in dysglycemia involved HCP interaction.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Data extraction was checked by two reviewers, and discordance was resolved by consensus.

“Data from the selected papers were extracted and then checked (TD and QO). Any discordance was resolved via discussion and consensus of the reviewers.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The protocol of this systematic review was prospectively registered at PROSPERO (CRD42024512690).

“The protocol of our systematic review was prospectively registered at PROSPERO (International Prospective Register of Systematic Reviews; registration number CRD42024512690).”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Titles and abstracts were screened twice by four reviewers, and full texts were independently evaluated by reviewers.

“Titles and abstracts of identified studies were screened twice (by TD, WW, QO, and LW) for potential eligibility using the inclusion and exclusion criteria. Full texts that met the inclusion criteria were retrieved and independently evaluated for their eligibility by the reviewers.”

Probably not a substantial claim: may not pass S4 (based).

This is the first systematic review to evaluate the effects of DHIs on the quadruple aims in T2DM prevention.

“This is the first systematic review to evaluate the effects of DHIs on the quadruple aims in T2DM prevention.”

May combine two claims.

Most neutral studies still demonstrated clinical improvements in T2DM development, though these improvements did not reach statistical significance.

“Despite this, most of these neutral studies still demonstrated clinical improvements in T2DM development, though these improvements did not reach statistical significance.”

Probably not a substantial claim: may not pass S4 (based).

This is the first systematic review of T2DM prevention using WHO's DHI classification.

“This is also the first systematic review of T2DM prevention using WHO’s DHI classification”

May combine two claims.

There is emerging evidence supporting the effectiveness of DHIs in preventing T2DM; however, the evidence remains limited.

“First, there is emerging evidence supporting the effectiveness of DHIs in preventing T2DM; however, the evidence remains limited.”

May combine two claims.

The evidence is clearer on dysglycemia, where the effects were positive in nearly half of the studies and neutral in the other half.

“The evidence is clearer on dysglycemia, where the effects were positive in nearly half of the studies and neutral in the other half.”

May combine two claims.

Although PPC or DCP did not prove effective in preventing T2DM, they showed evidence of improving dysglycemia.

“Although PPC or DCP did not prove effective in preventing T2DM, they showed evidence of improving dysglycemia.”

Probably not a substantial claim: may not pass S3 (load-bearing).

There is a significant correlation between TM and PHT.

“Consequently, there is a significant correlation between TM and PHT.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Our study did not summarize the intensity and frequency of the DHI used in each included study.

“Our study did not summarize the intensity and frequency of the DHI used in each included study.”

May combine two claims.

Advanced algorithms and data from everyday activities allowed AI to provide real-time, personalized, contextual lifestyle recommendations, contributing to patient-centered care.

“Advanced algorithms and data from everyday participants’ activities allowed AI to provide lifestyle recommendations, which were real time, personalized, and contextual for each participant, contributing to delivering patient-centered care [98].”

• cites [98] 2016, WHO Global Strategy on Integrated People-Centred Health Services 2016-2026Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

May combine two claims.

It was unfeasible to conduct a meta-analysis or certainty-of-evidence assessment due to the diversity of included studies.

“This diversity, while inclusive, posed challenges in drawing direct comparisons and made it unfeasible to conduct a meta-analysis or certainty-of-evidence assessment.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The inclusion criteria included papers in English only.

“Finally, our inclusion criteria included papers in English only.”

May combine two claims.

TCP was adopted in all included studies, demonstrating its widespread use and simplicity.

“In our review, TCP, which involves transmitting health information or health alerts and reminders to patients, was adopted in all included studies, demonstrating its widespread use and simplicity.”

Probably not a substantial claim: may not pass S2 (checkable).

Since preventing T2DM requires participants to modify lifestyles for a long period, DHIs that motivate and engage consumers may be more beneficial than DHIs targeting HCPs alone.

“Since preventing T2DM requires participants to modify lifestyles for a long period, DHIs that motivate and engage consumers may be more beneficial than DHIs targeting HCPs alone.”

May combine two claims.

HCP interaction plays a critical role in preventing T2DM, and replacing in-person HCP interactions with remote interactions has promising potential for effective DHIs for T2DM prevention.

“This underscores the critical role of HCP interaction in preventing T2DM, while also revealing the promising potential of replacing in-person HCP interactions with remote interactions for effective DHIs for T2DM prevention.”

May combine two claims.

TM may be effective in preventing T2DM and managing dysglycemia.

“Our review suggests that TM may be effective in preventing T2DM and managing dysglycemia.”

May combine two claims.

Although the findings in this review were different, the small number of studies suggests that it may still be feasible to implement DHIs that are cost-effective in T2DM prevention.

“Although the findings in our review were different, the small number of studies suggests that it may still be feasible to implement DHIs that are cost-effective in T2DM prevention.”

May combine two claims.

VR was used in 1 study, providing an immersive experience that increased participant engagement and enjoyment.

“VR was used in 1 study, providing an immersive experience that increased participant engagement and enjoyment [99].”

• cites [99] sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

The English-only inclusion criterion may have potentially excluded some relevant studies.

“This may have potentially excluded some relevant studies.”

May combine two claims.

TCP, PHT, and TM showed some evidence as potentially useful tools for T2DM prevention and dysglycemia.

“Targeted communication with persons (TCP), personal health tracking (PHT), and telemedicine (TM) showed some evidence as a potentially useful tool for T2DM prevention and dysglycemia.”

May combine two claims.

Recent evidence from diabetes prevention programs shows that long intervention durations are required for delaying T2DM, with the National Health Service recommending at least 9 months and the Centers for Disease Control and Prevention suggesting 12 months.

“However, recent evidence from DPPs that have proven to be successful shows that long intervention durations are required for delaying T2DM [88], with the National Health Service recommending at least 9 months and the Centers for Disease Control and Prevention suggesting 12 months.”

• cites [88] Diabetes prevention program (DPP)National Institutes of Health2025-04-18https://www.niddk.nih.gov/about-niddk/research-areas/diabetes/diabetes-prevention-program-dppNot matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.