Mobile App-Based Interventions to Support Diabetes Self-Management: A Systematic Review of Randomized Controlled Trials to Identify Functions Associated with Glycemic Efficacy
Open accessAbstract
Background: Mobile health apps for diabetes self-management have different functions. However, the efficacy and safety of each function are not well studied, and no classification is available for these functions. Objective: The aims of this study were to (1) develop and validate a taxonomy of apps for diabetes self-management, (2) investigate the glycemic efficacy of mobile app-based interventions among adults with diabetes in a systematic review of randomized controlled trials (RCTs), and (3) explore the contribution of different function to the effectiveness of entire app-based interventions using the taxonomy. Methods: We developed a 3-axis taxonomy with columns of clinical modules, rows of functional modules and cells of functions with risk assessments. This taxonomy was validated by reviewing and classifying commercially available diabetes apps. We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, the Chinese Biomedical Literature Database, and ClinicalTrials.gov from January 2007 to May 2016. We included RCTs of adult outpatients with diabetes that compared using mobile app-based interventions with usual care alone. The mean differences (MDs) in hemoglobin A1c (HbA1c) concentrations and risk ratios of adverse events were pooled using a random-effects meta-analysis. After taxonomic classification, we performed exploratory subgroup analyses of the presence or absence of each module across the included app-based interventions. Results: Across 12 included trials involving 974 participants, using app-based interventions was associated with a clinically significant reduction of HbA1c (MD 0.48%, 95% CI 0.19%-0.78%) without excess adverse events. Larger HbA1c reductions were noted among patients with type 2 diabetes than those with type 1 diabetes (MD 0.67%, 95% CI 0.30%-1.03% vs MD 0.37%, 95% CI –0.12%-0.86%). Having a complication prevention module in app-based interventions was associated with a greater HbA1c reduction (with complication prevention: MD 1.31%, 95% CI 0.66%-1.96% vs without: MD 0.38%, 95% CI 0.09%-0.67%; intersubgroup P=.01), as was having a structured display (with structured display: MD 0.69%, 95% CI 0.32%-1.06% vs without: MD 0.69%, 95% CI –0.18%-0.53%; intersubgroup P=.03). However, having a clinical decision-making function was not associated with a larger HbA1c reduction (with clinical decision making: MD 0.19%, 95% CI –0.24%-0.63% vs without: MD 0.61%, 95% CI 0.27%-0.95%; intersubgroup P=.14). Conclusions: The use of mobile app-based interventions yields a clinically significant HbA1c reduction among adult outpatients with diabetes, especially among those with type 2 diabetes. Our study suggests that the clinical decision-making function needs further improvement and evaluation before being added to apps.
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To utilize these types of BCTs, interventions usually included features such as self-monitoring of blood glucose, exercise, and diet; educational materials; and patient-healthcare provider communication.
“To utilize these types of BCTs, interventions usually included features such as self-monitoring of blood glucose, exercise, and diet; educational materials; and patient–healthcare provider communication.10,13,27”
From Effective behavioral change techniques in m-health app supported interventions for glycemic control among patients with type 2 diabetes: A meta-analysis and meta-regression analysis of randomized controlled trials (2025) · cites this paper as [27]
The Results (Characteristics and Classifications of Included Trials; page unavailable) report monitoring in all 12 apps, lifestyle modification in 11, patient–clinician communication in 9, and general education in 6. The taxonomy also describes logging diet and activity. These passages support the listed features, but the paper does not establish that they were included specifically to implement the cited behavior-change techniques, and education appeared in only half the interventions. (LLM, conf=0.83)
Experimental — accuracy not yet measuredWe chose 2007 as the starting year because most m-health apps were released after 2007.
“We chose 2007 as the starting year because most m-health apps were released after 2007.10,27”
From Effective behavioral change techniques in m-health app supported interventions for glycemic control among patients with type 2 diabetes: A meta-analysis and meta-regression analysis of randomized controlled trials (2025) · cites this paper as [27]
The Methods > Data Sources and Searches passage (page unavailable) says the review searched studies from January 1, 2007, but gives no reason for that start date. The Introduction discusses the number of available apps, not when most m-health apps were released. Our copy therefore does not establish the release-date claim. (LLM, conf=0.72)
Experimental — accuracy not yet measuredBenefits have been seen with the use of behavior change apps to drive improvements in glycemic control in people with diabetes through improved adherence to treatment protocols.
“Benefits have also been seen with the use of behavior change apps to drive improvements in glycemic control in people with diabetes through improved adherence to treatment protocols.”
From What is the clinical value of mHealth for patients? (2020) · cites this paper as [11]
Management-based mHealth interventions have been particularly successful at reducing HbA1c levels among people with T2DM.
“Management based interventions have proven to be particularly successful at reducing haemoglobin A 1c (HbA 1c ) levels amongst people with T2DM [14].”
From Cost and cost-effectiveness of mHealth interventions for the prevention and control of type 2 diabetes mellitus: A systematic review (2020) · cites this paper as [14]
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- Authors
- Wu, Y., Yao, X., Vespasiani, G., Nicolucci, A., Dong, Y., Kwong, J., Li, L., Sun, X., Tian, H., & Li, S.
- Affiliations
- Sichuan University (CN)
- Center for Outcomes Research and Clinical Epidemiology (IT)
- Corresponding author
- Li, Sheyu
- ORCID
- Venue
- JMIR mHealth and uHealth
- Publisher
- JMIR Publications Inc.
- Published
- 2017-03-14
- Volume
- 5
- Issue
- 3
- Pages
- e35
- ISSN
- 2291-5222 (ISSN-L)
- PMC
- PMC5373677
- OpenAlex
- W3159078634
- Cited by
- 283
- References
- 46
- Citations by year
- 2026: 13 · 2025: 23 · 2024: 24 · 2023: 20 · 2022: 35 · 2021: 27 · 2020: 44 · 2019: 48 · 2018: 33 · 2017: 16
- FWCI
- 6.79
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- JMIR mhealth and uhealth (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Natural Science Foundation of China (2015CB942800, 21534008, 81400811)
- Sichuan University
- National Key Research and Development Program of China (2015CB942800)
- West China Hospital, Sichuan University
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Keywords
- mobile health apps, diabetes self-management, glycemic control, HbA1c, type 1 diabetes, type 2 diabetes, complication prevention, adverse events, smartphone-based intervention, diabetes education, diabetes self-monitoring, medication reminders, exercise recommendations, sleep monitoring, blood glucose monitoring
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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