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Cited by 9Mobile Health and mHealth ApplicationsPhysical Activity and HealthContext-Aware Activity Recognition Systems

Effectiveness of wearable technologies in supporting physical activity and metabolic health in adults with type 2 diabetes: a systematic-narrative hybrid review

Open access
Laffi, Alessandra, Persiani, Michela, Piras, Alessandro, Meoni, Andrea, Raffi, Milena·2025·Healthcare
DOI 10.3390/healthcare13192422PMC PMC12524254
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Abstract

Background: Physical activity is essential in the prevention and management of type 2 diabetes mellitus (T2D), yet adherence to recommended activity levels remains insufficient. Wearable electronic devices have emerged as tools to support physical activity through self-monitoring and enhanced user engagement. This review synthesizes current evidence on the effectiveness of wearable technologies in improving adherence to physical activity and promoting clinical and metabolic health in adults with T2D. Methods: The review was conducted using systematic search strategies in PubMed and Scopus. We included studies that involved the use of wearable devices to monitor physical activity for at least seven consecutive days. The reported outcomes were related to physical activity adherence or clinical–metabolic health. Thirty-two studies met the inclusion criteria and were analyzed in terms of study design, device type, intervention characteristics, and outcomes. Results: Wearable devices were used either for monitoring daily activity in free-living conditions or within structured, often supervised, interventions. Most studies reported increased physical activity, particularly in step count. Several studies showed improvements in blood pressure and lipid profile, while results for HbA1c and BMI were mixed. Structured interventions with behavioural support produced more consistent and clinically relevant outcomes than passive monitoring alone. Conclusions: Wearable technologies can support physical activity in adults with T2D, especially when integrated into structured behavioural programmes. From a clinical standpoint, they may serve as useful tools to enhance lifestyle adherence, particularly when combined with professional support. Their inclusion in care pathways could help personalize interventions and improve long-term self-management.

AI snapshot

Written from the paper’s full text.

TL;DR

This systematic–narrative hybrid review synthesizes evidence on wearable technologies for physical activity and metabolic health in adults with type 2 diabetes. It concludes that wearables can support physical activity, but clinical impact depends more on structured behavioural support and clear targets than on device sophistication alone.

Key findings

  • The review included 31 studies: 23 randomized controlled trials, 7 observational studies (4 prospective/longitudinal and 3 cross-sectional), and 1 quasi-experimental pre–post study; the abstract states 32 studies, while the methods and results report 31.
  • Interventions were classified as structured and supervised (n = 7), structured but unsupervised (n = 15), and unstructured/monitoring-based (n = 9). Most studies reported increased physical activity, particularly step count.
  • Glycaemic results were mixed: across 15 structured but unsupervised publications, 8 reported significant within-group HbA1c reductions, but only 5 showed statistically significant differences versus controls. Blood pressure reductions appeared only when walking interventions included a BP-specific component such as home BP monitoring or structured cardiovascular counselling.
  • Device sophistication alone did not appear to drive efficacy; benefits were greatest when devices were integrated into structured, feedback-driven interventions with clear goals, regular monitoring, and personalized support.

Methods

  • Systematic search strategies were used in PubMed and Scopus for publications from 2015 to 2025, including adults >18 years with T2D, wearable devices used specifically for physical activity monitoring, direct assessment of physical activity adherence, and at least seven consecutive days of monitoring; English-language publications only.
  • Screening was conducted independently by three authors using a double-blind procedure, with disagreements resolved by consensus, and managed in Rayyan QCRI. From 1596 initially identified articles, 545 duplicates were removed, 1051 records were screened, 47 full texts were retrieved, and 31 articles were included after exclusions.
  • The review used a narrative synthesis with pragmatic categorization by intervention structure, supervision level, and device type; no meta-analysis is reported.

Limitations

  • Stated by the authors: included studies differed in design, device characteristics, intensity thresholds, outcome definitions, and follow-up duration, limiting direct comparability; inclusion was restricted to English-language publications; some full texts were unavailable; rapid technology evolution, frequent co-interventions, and differences in device placement or algorithms complicate attribution of effects to the wearable component alone.
  • Evident from the text: the abstract reports 32 included studies while the methods and results report 31, indicating an internal inconsistency.
  • Evident from the text: the review is narrative in nature despite systematic search and screening, and it does not report formal risk-of-bias assessment or quantitative pooling.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.3390/healthcare13192422

Cites

41 of 41 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 172 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    The review includes 31 studies that investigated the effectiveness of wearable technologies in promoting physical activity and improving clinical and metabolic outcomes in adults with type 2 diabetes.

    “This narrative review includes 31 studies that investigated the effectiveness of wearable technologies in promoting physical activity and improving clinical and metabolic outcomes in adults with T2D.”
    Quote in the paperSubstantial claim
  • Findingcitation

    Certain studies noted that pedometers may primarily detect vertical movements of the lower limbs, potentially limiting their ability to capture other types of physical activity such as upper-body motion or non-ambulatory tasks.

    “Nevertheless, certain studies have noted that these devices may primarily detect vertical movements of the lower limbs, potentially limiting their ability to capture other types of physical activity, such as upper-body motion or non-ambulatory tasks [13].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [13] Paula, 2015, Effects of the DASH Diet and Walking on Blood Pressure in Patients With Type 2 Diabetes and Uncontrolled Hypertension: A Randomized Controlled Trial, J. Clin. Hypertens. source

      Not checked in the free run.

  • Findingnone given

    Wearable devices employed across included studies varied significantly in technological complexity, interface usability, feedback capabilities, and user engagement required.

    “The wearable devices employed to monitor physical activity across the included studies varied significantly in terms of technological complexity, interface usability, feedback capabilities, and the level of user engagement required.”
    Quote in the paperNot a substantial claim
  • Findingcitation

    Several studies reported a decrease in sedentary time after the interventions.

    “Several studies reported a decrease in sedentary time after the interventions [16,24,30].”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [16] Balducci, S., D’Errico, V., Haxhi, J., Sacchetti, M., Orlando, G., Cardelli, P., Di Biase, N., Bollanti, L., Conti, F., and Zanuso, S. (2017). Level and correlates of physical activity and sedentary behavior in patients with type 2 diabetes: A cross-sectional analysis of the Italian Diabetes and Exercise Study_2. PLoS ONE, 12. source

      Not checked in the free run.

    • cites [24] Balducci, 2017, Effect of a Behavioral Intervention Strategy for Adoption and Maintenance of a Physically Active Lifestyle: The Italian Diabetes and Exercise Study 2 (IDES_2): A Randomized Controlled Trial, Diabetes Care. source

      Not checked in the free run.

    • cites [30] Haxhi, J., Vitale, M., Mattia, L., Giuliani, C., Sacchetti, M., Orlando, G., Iacobini, C., Menini, S., Zanuso, S., and Nicolucci, A. (2024). Effect of sustained decreases in sedentary time and increases in physical activity on liver enzymes and indices in type 2 diabetes. Front. Endocrinol., 15. source

      Not checked in the free run.

  • Findingnone given

    The studies were conducted across a diverse set of countries including the United States, Canada, the United Kingdom, Italy, France, Spain, Nigeria, South Africa, Malaysia, Oman, Indonesia, Japan, China, Brazil, Turkey, Israel, and Cameroon.

    “The studies were conducted across a diverse set of countries, including the United States, Canada, the United Kingdom, Italy, France, Spain, Nigeria, South Africa, Malaysia, Oman, Indonesia, Japan, China, Brazil, Turkey, Israel, and Cameroon.”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim. 20
  • May combine two claims. 62
  • The quote only partly states this claim. 3

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

    Findingreasoning

    Devices can be categorized into three main groups: pedometers, accelerometers, and multiparametric or integrated digital health systems.

    “Based on their functional roles and technological features, the devices can be categorized into three main groups: (1) pedometers, (2) accelerometers and (3) multiparametric or integrated digital health systems.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Thirty-two studies met the inclusion criteria and were analyzed in terms of study design, device type, intervention characteristics, and outcomes.

    “Thirty-two studies met the inclusion criteria and were analyzed in terms of study design, device type, intervention characteristics, and outcomes.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The populations studied varied widely in sample size (19 to over 4000 participants), age, gender distribution, and geographic setting.

    “The populations studied varied widely in sample size (ranging from 19 to over 4000 participants), age (from middle-aged adults to older populations), gender distribution, and geographic setting.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The majority of included studies were randomized controlled trials (n = 23), accompanied by seven observational studies and one quasi-experimental study.

    “The majority were randomized controlled trials (n = 23), accompanied by seven observational studies, comprising four with a prospective or longitudinal design [9,10,14,15] and three that were cross-sectional [16,17,18], along with one quasi-experimental study with a pre–post design and no control group [19].”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [9] Yang, 2020, Digital Phenotyping Self-Monitoring Behaviors for Individuals With Type 2 Diabetes Mellitus: Observational Study Using Latent Class Growth Analysis, JMIR Mhealth Uhealth source

      Not checked in the free run.

    • cites [10] Cao, 2024, Accelerometer-derived physical activity and mortality in individuals with type 2 diabetes, Nat. Commun. source

      Not checked in the free run.

    • cites [14] Masuda, 2021, Relationship Between Long-Term Objectively Measured Physical Activity and Glycemic Control in Type 2 Diabetes Mellitus Patients: A Prospective Cohort Study, Diabetes Metab. Syndr. Obes. source

      Not checked in the free run.

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

    Findingreasoning

    The final review included 31 articles.

    “In total, 31 articles were included in the final review.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingreasoning

    Modest reductions in body weight, BMI, and waist circumference were commonly reported in structured and supervised interventions, indicating improved body composition including increased lean mass and reduced visceral fat.

    “Modest reductions in body weight, BMI, and waist circumference were commonly reported, indicating improved body composition, including increased lean mass and reduced visceral fat.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    Studies by Alghafri et al., Johnson et al., and L.P. de Oliveira et al. found that incorporating step-tracking into educational or dietary programmes reduced sedentary behaviour and supported more consistent daily physical activity.

    “Additionally, studies by Alghafri et al., Johnson et al., and L.P. de Oliveira et al. found that incorporating step-tracking into educational or dietary programmes reduced sedentary behaviour and supported more consistent daily physical activity [12,21,31].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [12] Gubert, 2024, DASH diet vs. DASH diet plus physical activity in older patients with type 2 diabetes and high blood pressure: A randomized clinical trial, Nutr. Health source

      Not checked in the free run.

    • cites [21] Alghafri, 2018, ‘MOVEdiabetes’: A cluster randomized controlled trial to increase physical activity in adults with type 2 diabetes in primary health in Oman, BMJ Open Diabetes Res. Care. source

      Not checked in the free run.

    • cites [31] Johnson, 2015, Increase in Daily Steps After an Exercise Specialist Led Lifestyle Intervention for Adults with Type 2 Diabetes In Primary Care: A Controlled Implementation Trial, J. Phys. Act. Health source

      Not checked in the free run.

  • The quote only partly states this claim.

    Findingcitation

    Cardiorespiratory fitness improved in structured and supervised interventions, as indicated by increases in VO2max and better performance on functional walk tests such as the six-minute walk test.

    “Cardiorespiratory fitness also improved, as indicated by increases in VO2max and better performance on functional walk tests such as the six-minute walk test [16,24,25,27].”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [16] Balducci, S., D’Errico, V., Haxhi, J., Sacchetti, M., Orlando, G., Cardelli, P., Di Biase, N., Bollanti, L., Conti, F., and Zanuso, S. (2017). Level and correlates of physical activity and sedentary behavior in patients with type 2 diabetes: A cross-sectional analysis of the Italian Diabetes and Exercise Study_2. PLoS ONE, 12. source

      Not checked in the free run.

    • cites [24] Balducci, 2017, Effect of a Behavioral Intervention Strategy for Adoption and Maintenance of a Physically Active Lifestyle: The Italian Diabetes and Exercise Study 2 (IDES_2): A Randomized Controlled Trial, Diabetes Care. source

      Not checked in the free run.

    • cites [25] Balducci, 2022, Relationships of Changes in Physical Activity and Sedentary Behavior With Changes in Physical Fitness and Cardiometabolic Risk Profile in Individuals with Type 2 Diabetes: The Italian Diabetes and Exercise Study 2 (IDES_2), Diabetes Care source

      Not checked in the free run.

  • May combine two claims.

    Findingreasoning

    The magnitude of clinical and behavioural effects differs across structured but self-directed physical-activity programmes, and these differences align with the intensity and frequency of remote support offered to participants.

    “The magnitude of clinical and behavioural effects differs across structured, but self-directed physical-activity programmes and these differences align with the intensity and frequency of remote support offered to participants.”
    Quote in the paperSubstantial claim

  • The quote only partly states this claim.

    Findingnone given

    In structured but unsupervised interventions, significant increases in physical activity compared with control groups were observed in interventions involving moderate to high levels of support.

    “Significant increases in the amount of physical activity compared with control groups were observed in interventions involving moderate to high levels of support, with each study emphasizing distinct elements that contributed to their effectiveness.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    Yom-Tov et al. showed that SMS messages generated through reinforcement learning significantly increased both the amount and speed of walking.

    “Yom-Tov et al., showed that SMS messages generated through reinforcement learning significantly increased both the amount and speed of walking, underscoring the impact of highly personalized communication [38].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [38] Feraru, 2017, Encouraging Physical Activity in Patients With Diabetes: Intervention Using a Reinforcement Learning System, J. Med. Internet Res. source

      Not checked in the free run.

  • May combine two claims.

    Findingreasoning

    Neither increased technological sophistication nor greater intensity of support translated into superior glycaemic outcomes.

    “Notably, neither increased technological sophistication nor greater intensity of support translated into superior glycaemic outcomes.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    Significant between-group differences in structured and supervised interventions were sometimes observed in the short term but were not always maintained over time, with improvements generally aligning with greater increases in physical activity and reductions in sedentary behaviour.

    “While significant between-group differences were sometimes observed in the short term, these were not always maintained over time, with improvements generally aligning with greater increases in physical activity and reductions in sedentary behaviour [22,30].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [22] 2019, Effect of a multifactorial intervention on the increase in physical activity in subjects with type 2 diabetes mellitus: A randomized clinical trial (EMID Study), Eur. J. Cardiovasc. Nurs. source

      Not checked in the free run.

    • cites [30] Haxhi, J., Vitale, M., Mattia, L., Giuliani, C., Sacchetti, M., Orlando, G., Iacobini, C., Menini, S., Zanuso, S., and Nicolucci, A. (2024). Effect of sustained decreases in sedentary time and increases in physical activity on liver enzymes and indices in type 2 diabetes. Front. Endocrinol., 15. source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Interventions incorporating bidirectional messaging or web-based platforms did not demonstrate greater efficacy than usual care, and the initially favourable effect observed in Miyauchi et al. was no longer evident at six-month follow-up.

    “Interventions incorporating bidirectional messaging or web-based platforms did not demonstrate greater efficacy than usual care, and the initially favourable effect observed in Miyauchi et al. was no longer evident at the six-month follow-up [7,8,20,32].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [7] Miyauchi, 2016, Exercise Therapy for Management of Type 2 Diabetes Mellitus: Superior Efficacy of Activity Monitors over Pedometers, J. Diabetes Res. source

      Not checked in the free run.

    • cites [8] Kooiman, 2018, Self-tracking of Physical Activity in People With Type 2 Diabetes: A Randomized Controlled Trial, Comput. Inform. Nurs.

      Not checked in the free run.

    • cites [20] Agboola, 2016, Text to Move: A Randomized Controlled Trial of a Text-Messaging Program to Improve Physical Activity Behaviors in Patients With Type 2 Diabetes Mellitus, J. Med. Internet Res. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Findingreasoning

    Based on predefined criteria, interventions were classified into three categories: structured and supervised (n = 7), structured but unsupervised (n = 15), and unstructured and/or monitoring-based (n = 9).

    “Based on these criteria, the interventions were classified into three categories: structured and supervised (n = 7), structured but unsupervised (n = 15), and unstructured and/or monitoring-based interventions (n = 9).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    Structured and supervised interventions led to a more favourable metabolic profile, with reductions in LDL cholesterol and triglycerides and improvements in fasting glucose, as well as attenuated systemic inflammation evidenced by decreases in inflammatory markers like high-sensitivity C-reactive protein.

    “These interventions also led to a more favourable metabolic profile, with reductions in LDL cholesterol and triglycerides and improvements in fasting glucose, as well as attenuated systemic inflammation evidenced by decreases in inflammatory markers like high-sensitivity C-reactive protein [24,25,30].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [24] Balducci, 2017, Effect of a Behavioral Intervention Strategy for Adoption and Maintenance of a Physically Active Lifestyle: The Italian Diabetes and Exercise Study 2 (IDES_2): A Randomized Controlled Trial, Diabetes Care. source

      Not checked in the free run.

    • cites [25] Balducci, 2022, Relationships of Changes in Physical Activity and Sedentary Behavior With Changes in Physical Fitness and Cardiometabolic Risk Profile in Individuals with Type 2 Diabetes: The Italian Diabetes and Exercise Study 2 (IDES_2), Diabetes Care source

      Not checked in the free run.

    • cites [30] Haxhi, J., Vitale, M., Mattia, L., Giuliani, C., Sacchetti, M., Orlando, G., Iacobini, C., Menini, S., Zanuso, S., and Nicolucci, A. (2024). Effect of sustained decreases in sedentary time and increases in physical activity on liver enzymes and indices in type 2 diabetes. Front. Endocrinol., 15. source

      Not checked in the free run.

  • May combine two claims.

    Findingnone given

    Muscular strength increased in structured and supervised interventions, particularly in protocols including resistance training, and in several cases improvements were significantly greater in intervention groups than controls.

    “Muscular strength increased, particularly in protocols including resistance training, and in several cases, these improvements were significantly greater in intervention groups than in controls.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    Eight studies reported significant reductions in HbA1c within the intervention groups; only five demonstrated a statistically significant difference compared to control groups.

    “Eight studies reported significant reductions in HbA1c within the intervention groups; however, only five demonstrated a statistically significant difference when compared to their respective control groups [7,18,28,34,38].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [7] Miyauchi, 2016, Exercise Therapy for Management of Type 2 Diabetes Mellitus: Superior Efficacy of Activity Monitors over Pedometers, J. Diabetes Res. source

      Not checked in the free run.

    • cites [18] Siddiqui, 2018, The relationship between objectively measured physical activity and parameters of disease control in an African population of type 2 diabetes mellitus, J. Endocrinol. Metab. Diabetes South. Afr. source

      Not checked in the free run.

    • cites [28] Fayehun, 2018, Walking prescription of 10 000 steps per day in patients with type 2 diabetes mellitus: A randomised trial in Nigerian general practice, Br. J. Gen. Pract. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Findingnone given

    The categorization underscores heterogeneity in intervention design across included studies.

    “This categorization underscores the heterogeneity in intervention design across the included studies.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    Several structured and supervised interventions resulted in improved liver function, including reductions in hepatic enzyme levels (ALT, γ-GT), better scores on indices of non-alcoholic fatty liver disease (NAFLD), suggesting a decrease in ectopic liver fat.

    “In addition, several interventions resulted in improved liver function, including reductions in hepatic enzyme levels (ALT, γ-GT), as well as better scores on indices of non-alcoholic fatty liver disease (NAFLD), suggesting a decrease in ectopic liver fat [22,37].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [22] 2019, Effect of a multifactorial intervention on the increase in physical activity in subjects with type 2 diabetes mellitus: A randomized clinical trial (EMID Study), Eur. J. Cardiovasc. Nurs. source

      Not checked in the free run.

    • cites [37] Timurtas, 2022, Technology-based and supervised exercise interventions for individuals with type 2 diabetes: Randomized controlled trial, Prim. Care Diabetes source

      Not checked in the free run.

  • May combine two claims.

    Findingnone given

    An intervention duration of at least 10 to 13 weeks appears necessary to produce consistent effects on HbA1c, while shorter or markedly longer approaches have yielded mixed results.

    “Moreover, an intervention duration of at least 10 to 13 weeks appears necessary to produce consistent effects, while shorter or markedly longer approaches have yielded mixed results.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    Programmes focused on periodic counselling sessions were effective in increasing ambulatory activity but did not produce significant changes in HbA1c compared to control conditions.

    “Similarly, programmes focused on periodic counselling sessions were effective in increasing ambulatory activity but did not produce significant changes in HbA1c compared to control conditions [12,21,31,35].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [12] Gubert, 2024, DASH diet vs. DASH diet plus physical activity in older patients with type 2 diabetes and high blood pressure: A randomized clinical trial, Nutr. Health source

      Not checked in the free run.

    • cites [21] Alghafri, 2018, ‘MOVEdiabetes’: A cluster randomized controlled trial to increase physical activity in adults with type 2 diabetes in primary health in Oman, BMJ Open Diabetes Res. Care. source

      Not checked in the free run.

    • cites [31] Johnson, 2015, Increase in Daily Steps After an Exercise Specialist Led Lifestyle Intervention for Adults with Type 2 Diabetes In Primary Care: A Controlled Implementation Trial, J. Phys. Act. Health source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Adherence to digital monitoring tools appeared to correlate with more favourable baseline and follow-up HbA1c values, though not with change over time.

    “adherence to digital monitoring tools appeared to correlate with more favourable baseline and follow-up HbA1c values, though not with change over time [9].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [9] Yang, 2020, Digital Phenotyping Self-Monitoring Behaviors for Individuals With Type 2 Diabetes Mellitus: Observational Study Using Latent Class Growth Analysis, JMIR Mhealth Uhealth source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Behaviourally focused approaches like motivational interviewing, which encouraged adherence to official physical activity recommendations, led to greater reductions in serum glucose, though effects on HbA1c were less pronounced.

    “In other cases, behaviourally focused approaches like motivational interviewing, which encouraged adherence to official physical activity recommendations, led to greater reductions in serum glucose, though effects on HbA1c were less pronounced [26].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [26] Chlebowy, 2015, Motivational interviewing to improve diabetes outcomes in African Americans adults with diabetes, West. J. Nurs. Res. source

      Not checked in the free run.

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    Findingcitation

    Body composition outcomes were generally neutral across the studies, with few interventions showing significant between-group effects.

    “Body composition outcomes were generally neutral across the studies, with few interventions showing significant between-group effects.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingnone given

    Wearable devices were used either for monitoring daily activity in free-living conditions or within structured, often supervised, interventions.

    “Wearable devices were used either for monitoring daily activity in free-living conditions or within structured, often supervised, interventions.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingreasoning

    The clinical outcomes reported across the nine studies in this category reveal a heterogeneous picture, particularly in relation to glycaemic control, with several interventions associated with improvements in glycaemic parameters, although the magnitude and consistency of effects varied.

    “Based on these observations, the clinical outcomes reported across the nine studies in this category reveal a heterogeneous picture, particularly in relation to glycaemic control, with several interventions associated with improvements in glycaemic parameters, although the magnitude and consistency of effects varied.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    Higher levels of daily physical activity were associated with lower all-cause, cardiovascular, and cancer-related mortality, with clear dose-response relationships observed.

    “One large-scale observational analysis found that higher levels of daily physical activity were associated with lower all-cause, cardiovascular, and cancer-related mortality, with clear dose–response relationships observed [10].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [10] Cao, 2024, Accelerometer-derived physical activity and mortality in individuals with type 2 diabetes, Nat. Commun. source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Structured lifestyle trials that include regular coaching or digital support often led to modest drops in body weight and BMI within the intervention arm, but these changes rarely reached statistical significance when compared with usual-care controls.

    “Structured lifestyle trials that include regular coaching or digital support often led to modest drops in body weight and BMI within the intervention arm, but these changes rarely reached statistical significance when compared with usual-care controls [8,12,20,21,31].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [8] Kooiman, 2018, Self-tracking of Physical Activity in People With Type 2 Diabetes: A Randomized Controlled Trial, Comput. Inform. Nurs.

      Not checked in the free run.

    • cites [12] Gubert, 2024, DASH diet vs. DASH diet plus physical activity in older patients with type 2 diabetes and high blood pressure: A randomized clinical trial, Nutr. Health source

      Not checked in the free run.

    • cites [20] Agboola, 2016, Text to Move: A Randomized Controlled Trial of a Text-Messaging Program to Improve Physical Activity Behaviors in Patients With Type 2 Diabetes Mellitus, J. Med. Internet Res. source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Interventions focused almost exclusively on step targets remained neutral with respect to blood pressure, despite improving other metabolic markers.

    “Interventions focused almost exclusively on step targets remained neutral with respect to BP, despite improving other metabolic markers [28,31,34,35].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [28] Fayehun, 2018, Walking prescription of 10 000 steps per day in patients with type 2 diabetes mellitus: A randomised trial in Nigerian general practice, Br. J. Gen. Pract. source

      Not checked in the free run.

    • cites [31] Johnson, 2015, Increase in Daily Steps After an Exercise Specialist Led Lifestyle Intervention for Adults with Type 2 Diabetes In Primary Care: A Controlled Implementation Trial, J. Phys. Act. Health source

      Not checked in the free run.

    • cites [34] Rekha, 2020, Impact of pedometer based physical activity on glycemic control and body composition of type 2 diabetes mellitus patients, Biomedicine

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    A small reduction in systolic pressure was observed among participants with higher physical activity levels, though diastolic values remained unchanged.

    “A small reduction in systolic pressure was observed among participants with higher physical activity levels [17], though diastolic values remained unchanged.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [17] Cirilli, 2019, Three Months Monitored Metabolic Fitness Modulates Cardiovascular Risk Factors in Diabetic Patients, Diabetes Metab. J. source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Several other trials that combined objective measurements with lighter support failed to replicate fat-mass benefits, suggesting that both the specific design of the intervention and the intensity of follow-up are critical determinants of success.

    “Still, several other trials that combined objective measurements with lighter support failed to replicate these benefits [12,34], suggesting that both the specific design of the intervention and the intensity of follow-up are critical determinants of success.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [12] Gubert, 2024, DASH diet vs. DASH diet plus physical activity in older patients with type 2 diabetes and high blood pressure: A randomized clinical trial, Nutr. Health source

      Not checked in the free run.

    • cites [34] Rekha, 2020, Impact of pedometer based physical activity on glycemic control and body composition of type 2 diabetes mellitus patients, Biomedicine

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    One study found a favourable shift in the ratio of visceral to total adipose tissue in participants with higher physical activity levels, though overall fat and lean mass remained unchanged.

    “One study found a favourable shift in the ratio of visceral to total adipose tissue in participants with higher physical activity levels, though overall fat and lean mass remained unchanged [17].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [17] Cirilli, 2019, Three Months Monitored Metabolic Fitness Modulates Cardiovascular Risk Factors in Diabetic Patients, Diabetes Metab. J. source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Programmes incorporating counselling or real-time feedback showed broader benefits, including reduced medication use and improved functional capacity, such as endurance, gait speed, and walking performance.

    “Additionally, programmes incorporating counselling or real-time feedback showed broader benefits, including reduced medication use and improved functional capacity, such as endurance, gait speed, and walking performance [19,29,32,35].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [19] Jiwani, 2021, A geriatrics walking clinic improves hemoglobin A1c and timed gait in older veterans with type 2 diabetes, Geriatr. Nurs. source

      Not checked in the free run.

    • cites [29] Gu, 2020, Effects of self-monitoring devices on blood pressure in older adults with hypertension and diabetes: A randomised controlled trial, J. Epidemiol. Community Health source

      Not checked in the free run.

    • cites [32] Li, 2021, Efficiency of an mHealth App and Chest-Wearable Remote Exercise Monitoring Intervention in Patients With Type 2 Diabetes: A Prospective, Multicenter Randomized Controlled Trial, JMIR Mhealth Uhealth source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Increased activity levels were inversely associated with oxidative stress markers and were linked to improvements in endothelial function and lipid oxidation parameters.

    “Another study reported that increased activity levels were inversely associated with oxidative stress markers and were linked to improvements in endothelial function and lipid oxidation parameters [17].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [17] Cirilli, 2019, Three Months Monitored Metabolic Fitness Modulates Cardiovascular Risk Factors in Diabetic Patients, Diabetes Metab. J. source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Dropout rates tended to be higher in studies involving structured but unsupervised interventions, where technological issues and lack of sustained motivation were common contributing factors.

    “Dropout rates tended to be higher in studies involving structured but unsupervised interventions, where technological issues and lack of sustained motivation were common contributing factors.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    Discomfort with monitoring devices and joint pain, together with loss of interest and difficulty sustaining motivation, further compromised adherence.

    “In some cases, discomfort with monitoring devices and joint pain, together with loss of interest and difficulty sustaining motivation, further compromised adherence [21,28].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [21] Alghafri, 2018, ‘MOVEdiabetes’: A cluster randomized controlled trial to increase physical activity in adults with type 2 diabetes in primary health in Oman, BMJ Open Diabetes Res. Care. source

      Not checked in the free run.

    • cites [28] Fayehun, 2018, Walking prescription of 10 000 steps per day in patients with type 2 diabetes mellitus: A randomised trial in Nigerian general practice, Br. J. Gen. Pract. source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    While some unstructured or passively monitored programmes demonstrated modest increases in activity levels or positive metabolic associations, the results were inconsistent and often context-dependent.

    “While some of these programmes demonstrated modest increases in activity levels or positive metabolic associations, the results were inconsistent and often context-dependent [15,17,23].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [15] Gauthier, 2023, Impact of sleep and physical activity habits on real-life glycaemic variability in patients with type 2 diabetes, J. Sleep. Res. source

      Not checked in the free run.

    • cites [17] Cirilli, 2019, Three Months Monitored Metabolic Fitness Modulates Cardiovascular Risk Factors in Diabetic Patients, Diabetes Metab. J. source

      Not checked in the free run.

    • cites [23] Arovah, 2018, Walking with Diabetes (WW-DIAB) programme a walking programme for Indonesian type 2 diabetes mellitus patients: A pilot randomised controlled trial, SAGE Open Med. source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Sociodemographic and clinical factors were occasionally associated with higher attrition, with participants who discontinued often being younger, having higher BMI, lower baseline fitness or self-efficacy, and more frequently being women.

    “Sociodemographic and clinical factors were occasionally associated with higher attrition, with participants who discontinued often being younger, having higher BMI, lower baseline fitness or self-efficacy, and more frequently being women [31,35].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [31] Johnson, 2015, Increase in Daily Steps After an Exercise Specialist Led Lifestyle Intervention for Adults with Type 2 Diabetes In Primary Care: A Controlled Implementation Trial, J. Phys. Act. Health source

      Not checked in the free run.

    • cites [35] Sazlina, S.G., Browning, C.J., and Yasin, S. (2015). Effectiveness of Personalized Feedback Alone or Combined with Peer Support to Improve Physical Activity in Sedentary Older Malays with Type 2 Diabetes: A Randomized Controlled Trial. Front. Public Health, 3. source

      Not checked in the free run.

  • May combine two claims.

    Findingreasoning

    The primary reasons for disengagement included technical difficulties, reduced motivation over time, sociodemographic vulnerability and discomfort or unfamiliarity with the monitoring devices.

    “The primary reasons for disengagement included technical difficulties (e.g., connectivity issues or device malfunction), reduced motivation over time, sociodemographic vulnerability and discomfort or unfamiliarity with the monitoring devices.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Wearable technologies are accessible and relatively affordable, representing promising complements to traditional care.

    “owing to their accessibility and relative affordability, these technologies represent promising complements to traditional care [8,9,10].”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [8] Kooiman, 2018, Self-tracking of Physical Activity in People With Type 2 Diabetes: A Randomized Controlled Trial, Comput. Inform. Nurs.

      Not checked in the free run.

    • cites [9] Yang, 2020, Digital Phenotyping Self-Monitoring Behaviors for Individuals With Type 2 Diabetes Mellitus: Observational Study Using Latent Class Growth Analysis, JMIR Mhealth Uhealth source

      Not checked in the free run.

    • cites [10] Cao, 2024, Accelerometer-derived physical activity and mortality in individuals with type 2 diabetes, Nat. Commun. source

      Not checked in the free run.

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

    Premisecitation

    Wearable activity-tracking technologies have garnered growing attention as tools to encourage physical activity and support self-management in people with chronic conditions such as type 2 diabetes.

    “In recent years, wearable activity-tracking technologies, including pedometers, accelerometers, fitness trackers, smartwatches, and smartphone-based applications, have garnered growing attention as tools to encourage physical activity and support self-management in people living with chronic conditions such as T2D.”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [8] Kooiman, 2018, Self-tracking of Physical Activity in People With Type 2 Diabetes: A Randomized Controlled Trial, Comput. Inform. Nurs.

      Not checked in the free run.

    • cites [9] Yang, 2020, Digital Phenotyping Self-Monitoring Behaviors for Individuals With Type 2 Diabetes Mellitus: Observational Study Using Latent Class Growth Analysis, JMIR Mhealth Uhealth source

      Not checked in the free run.

    • cites [10] Cao, 2024, Accelerometer-derived physical activity and mortality in individuals with type 2 diabetes, Nat. Commun. source

      Not checked in the free run.

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

    Premisecitation

    Accelerometers record movement acceleration, enabling quantification of physical activity and sedentary time under real-life conditions.

    “These devices record movement acceleration, enabling the quantification of physical activity and sedentary time under real-life conditions [10,24].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [10] Cao, 2024, Accelerometer-derived physical activity and mortality in individuals with type 2 diabetes, Nat. Commun. source

      Not checked in the free run.

    • cites [24] Balducci, 2017, Effect of a Behavioral Intervention Strategy for Adoption and Maintenance of a Physically Active Lifestyle: The Italian Diabetes and Exercise Study 2 (IDES_2): A Randomized Controlled Trial, Diabetes Care. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Accelerometers provide continuous and accurate data, including the ability to detect low-intensity movements.

    “They provide continuous and accurate data, including the ability to detect low-intensity movements [10,17].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [10] Cao, 2024, Accelerometer-derived physical activity and mortality in individuals with type 2 diabetes, Nat. Commun. source

      Not checked in the free run.

    • cites [17] Cirilli, 2019, Three Months Monitored Metabolic Fitness Modulates Cardiovascular Risk Factors in Diabetic Patients, Diabetes Metab. J. source

      Not checked in the free run.

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

    Study design and conductnone given

    The review adopted a systematic approach in literature search and screening/selection to improve transparency and reproducibility.

    “Although the review is narrative in nature, a systematic approach was adopted in the literature search and screening and selection processes to improve the transparency and reproducibility of the results.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    Study selection was conducted independently by three authors using a double-blind screening procedure, with disagreements resolved by consensus.

    “The selection of studies was conducted independently by three authors (A.L., M.R. and M.P.) using a double-blind screening procedure. Each investigator assessed the titles, abstracts, and full texts of potentially eligible studies without knowledge of the other’s decisions. Disagreements were resolved through consensus-based discussion in order to minimize selection bias and enhance methodological”
    Quote in the paperNot a substantial claim

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

    Premisecitation

    Wearable devices offer functionalities such as real-time feedback, step counting, heart rate monitoring, and behaviour-based prompts to foster sustained engagement in physical activity.

    “These devices offer functionalities like real-time feedback, step counting, heart rate monitoring, and behaviour-based prompts to foster sustained engagement in physical activity.”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [8] Kooiman, 2018, Self-tracking of Physical Activity in People With Type 2 Diabetes: A Randomized Controlled Trial, Comput. Inform. Nurs.

      Not checked in the free run.

    • cites [9] Yang, 2020, Digital Phenotyping Self-Monitoring Behaviors for Individuals With Type 2 Diabetes Mellitus: Observational Study Using Latent Class Growth Analysis, JMIR Mhealth Uhealth source

      Not checked in the free run.

    • cites [10] Cao, 2024, Accelerometer-derived physical activity and mortality in individuals with type 2 diabetes, Nat. Commun. source

      Not checked in the free run.

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

    Study design and conductreasoning

    All included studies required a minimum physical activity monitoring period of seven consecutive days.

    “All included studies required a minimum physical activity monitoring period of seven consecutive days, consistent with the review’s eligibility criteria.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationcitation

    Overall, supervised exercise confers multi-faceted improvements in glycemic control, fitness, anthropometric measures, cardiovascular risk factors, inflammation, and liver health in people with type 2 diabetes.

    “Overall, despite minor variability in the magnitude of changes across individual studies, the pattern of results is strikingly consistent: supervised exercise confers multi-faceted improvements in glycemic control, fitness, anthropometric measures, cardiovascular risk factors, inflammation, and liver health in people with type 2 diabetes [16,24,25,27].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [16] Balducci, S., D’Errico, V., Haxhi, J., Sacchetti, M., Orlando, G., Cardelli, P., Di Biase, N., Bollanti, L., Conti, F., and Zanuso, S. (2017). Level and correlates of physical activity and sedentary behavior in patients with type 2 diabetes: A cross-sectional analysis of the Italian Diabetes and Exercise Study_2. PLoS ONE, 12. source

      Not checked in the free run.

    • cites [24] Balducci, 2017, Effect of a Behavioral Intervention Strategy for Adoption and Maintenance of a Physically Active Lifestyle: The Italian Diabetes and Exercise Study 2 (IDES_2): A Randomized Controlled Trial, Diabetes Care. source

      Not checked in the free run.

    • cites [25] Balducci, 2022, Relationships of Changes in Physical Activity and Sedentary Behavior With Changes in Physical Fitness and Cardiometabolic Risk Profile in Individuals with Type 2 Diabetes: The Italian Diabetes and Exercise Study 2 (IDES_2), Diabetes Care source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Interpretationreasoning

    Objectively monitoring physical activity through wearable devices or mobile applications is more accurate and effective than relying on self-reported behaviour.

    “In this context, objectively monitoring physical activity through wearable devices or mobile applications is more accurate and effective than relying on self-reported behaviour.”
    Quote in the paperNot a substantial claim

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

    Interpretationreasoning

    The diversity of countries provides a comprehensive and representative perspective on how wearable technologies are being implemented across both clinical and real-world settings in the management of type 2 diabetes.

    “This diversity provides a comprehensive and representative perspective on how wearable technologies are being implemented across both clinical and real-world settings in the management of T2D.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    Both absolute and daily activity patterns, as well as monitoring behaviours, may be relevant for glycaemic management even in the absence of formal exercise prescriptions.

    “Collectively, these findings suggest that both absolute and daily activity patterns, as well as monitoring behaviours, may be relevant for glycaemic management even in the absence of formal exercise prescriptions.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    Increased walking lowers blood pressure only when paired with objective BP monitoring or structured cardiovascular counselling; step goals alone do not yield a clinically meaningful effect.

    “In summary, increased walking lowers blood pressure only when paired with objective BP monitoring or structured cardiovascular counselling; step goals alone do not yield a clinically meaningful effect.”
    Quote in the paperSubstantial claim

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

    Interpretationreasoning

    Inclusion of wearable technologies in care pathways could help personalize interventions and improve long-term self-management.

    “Their inclusion in care pathways could help personalize interventions and improve long-term self-management.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    Wearable technologies can support physical activity in adults with type 2 diabetes, especially when integrated into structured behavioural programmes.

    “Wearable technologies can support physical activity in adults with T2D, especially when integrated into structured behavioural programmes.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationcitation

    Enhanced daily activity may contribute to long-term reductions in T2D complications and cardiovascular mortality risk.

    “Although not directly assessing clinical outcomes, other investigations suggested that enhanced daily activity may contribute to long-term reductions in T2D complications and cardiovascular mortality risk [23].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [23] Arovah, 2018, Walking with Diabetes (WW-DIAB) programme a walking programme for Indonesian type 2 diabetes mellitus patients: A pilot randomised controlled trial, SAGE Open Med. source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    When aligned with structured guidance, regular monitoring, and sustained feedback, wearable technologies can enhance engagement with physical activity and contribute meaningfully to long-term self-management.

    “When aligned with structured guidance, regular monitoring, and sustained feedback, these technologies can enhance engagement with physical activity and contribute meaningfully to long-term self-management [12,31,34,35].”
    Quote in the paperSubstantial claim0 of 4 sources checked
    • cites [12] Gubert, 2024, DASH diet vs. DASH diet plus physical activity in older patients with type 2 diabetes and high blood pressure: A randomized clinical trial, Nutr. Health source

      Not checked in the free run.

    • cites [31] Johnson, 2015, Increase in Daily Steps After an Exercise Specialist Led Lifestyle Intervention for Adults with Type 2 Diabetes In Primary Care: A Controlled Implementation Trial, J. Phys. Act. Health source

      Not checked in the free run.

    • cites [34] Rekha, 2020, Impact of pedometer based physical activity on glycemic control and body composition of type 2 diabetes mellitus patients, Biomedicine

      Not checked in the free run.

    • cites [35] Sazlina, S.G., Browning, C.J., and Yasin, S. (2015). Effectiveness of Personalized Feedback Alone or Combined with Peer Support to Improve Physical Activity in Sedentary Older Malays with Type 2 Diabetes: A Randomized Controlled Trial. Front. Public Health, 3. source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Interventions lacking precise behavioural targets or sufficient intensity often have limited impact on HbA1c, suggesting that goal clarity and intervention design are as important as the technology itself.

    “Interventions lacking precise behavioural targets or sufficient intensity often have limited impact on HbA1c, suggesting that goal clarity and intervention design are as important as the technology itself.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    Wearables appear most effective when aligned with structured prescriptions (e.g., step goals, intensity thresholds) and when the feedback loop reinforces these targets in real time.

    “Wearables appear most effective when aligned with structured prescriptions (e.g., step goals, intensity thresholds) and when the feedback loop reinforces these targets in real time.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    Supervised exercise models are associated with high levels of adherence and retention, but personal and logistical barriers may still limit long-term participation.

    “While such models are associated with high levels of adherence and retention, personal and logistical barriers (e.g., illness, transportation, competing responsibilities) may still limit long-term participation.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    Supervision appears to enhance adherence by promoting accountability, structured engagement, and social support, though personal and logistical barriers remain significant obstacles to sustained participation.

    “Overall, supervision appears to enhance adherence by promoting accountability, structured engagement, and social support, though personal and logistical barriers remain significant obstacles to sustained participation.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Premisecitation

    Within contemporary T2D management, nursing assumes a central role when combined with Lifestyle Medicine principles and the digitalisation of care.

    “Within contemporary T2D management, nursing assumes a central role when combined with Lifestyle Medicine principles and the digitalisation of care [11,39,40,41].”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [11] Alhaiti, A. (2025). Integrative technologies in nursing-led interventions for diabetes management: A systematic review of efficacy and outcomes. BMC Nurs., 24. source

      Not checked in the free run.

    • cites [39] Cangelosi, 2024, Lifestyle Medicine Case Manager Nurses for Type Two Diabetes Patients: An Overview of a Job Description Framework—A Narrative Review, Diabetology source

      Not checked in the free run.

    • cites [40] Zhang, 2022, Nurse-led care versus usual care on cardiovascular risk factors for patients with type 2 diabetes: A systematic review and meta-analysis, BMJ Open source

      Not checked in the free run.

    • cites [41] Kerr, 2024, Digital Interventions for Self-Management of Type 2 Diabetes Mellitus: Systematic Literature Review and Meta-Analysis, J. Med. Internet Res. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Compared with usual care, nurse led models, characterized by structured education, proactive follow-up, and protocol-driven treatment adjustments, consistently produce modest but clinically relevant improvements in intermediate outcomes, including HbA1c, systolic blood pressure, and BMI, alongside stronger self-care behaviours.

    “Compared with usual care, nurse led models, characterized by structured education, proactive follow-up, and protocol-driven treatment adjustments, consistently produce modest but clinically relevant improvements in intermediate outcomes. Benefits are observed for HbA1c, systolic blood pressure, and BMI, alongside stronger self-care behaviours.”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [11] Alhaiti, A. (2025). Integrative technologies in nursing-led interventions for diabetes management: A systematic review of efficacy and outcomes. BMC Nurs., 24. source

      Not checked in the free run.

    • cites [40] Zhang, 2022, Nurse-led care versus usual care on cardiovascular risk factors for patients with type 2 diabetes: A systematic review and meta-analysis, BMJ Open source

      Not checked in the free run.

    • cites [41] Kerr, 2024, Digital Interventions for Self-Management of Type 2 Diabetes Mellitus: Systematic Literature Review and Meta-Analysis, J. Med. Internet Res. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Interventions in nurse led, digitally enabled programmes vary in content, intensity and duration; effects from tightly controlled trials may not generalize to routine services; and scaling is difficult because high contact models require substantial staff time, training and robust digital infrastructure.

    “Despite favourable signals, several limitations warrant attention: interventions vary in content, intensity and duration; effects from tightly controlled trials may not generalize to routine services; and scaling is difficult because high contact models require substantial staff time, training and robust digital infrastructure [11,40,41].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [11] Alhaiti, A. (2025). Integrative technologies in nursing-led interventions for diabetes management: A systematic review of efficacy and outcomes. BMC Nurs., 24. source

      Not checked in the free run.

    • cites [40] Zhang, 2022, Nurse-led care versus usual care on cardiovascular risk factors for patients with type 2 diabetes: A systematic review and meta-analysis, BMJ Open source

      Not checked in the free run.

    • cites [41] Kerr, 2024, Digital Interventions for Self-Management of Type 2 Diabetes Mellitus: Systematic Literature Review and Meta-Analysis, J. Med. Internet Res. source

      Not checked in the free run.

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

    Study design and conductnone given

    Clear eligibility criteria, a pragmatic classification by intervention structure, level of supervision and device type, and the requirement for at least seven consecutive days of monitoring help make comparisons meaningful and link the findings to clinical practice.

    “Clear eligibility criteria, a pragmatic classification by intervention structure, level of supervision and device type, and the requirement for at least seven consecutive days of monitoring help make comparisons meaningful and link the findings to clinical practice.”
    Quote in the paperSubstantial claim

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

    Study design and conductnone given

    Inclusion was restricted to English language publications and a small number of full texts were unavailable.

    “Inclusion was restricted to English language publications and a small number of full texts were unavailable.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Evidence for nurse led, digitally enabled programmes, including telemonitoring, app supported education for diabetes self-management and structured messaging, shows feasibility, acceptability and reductions in HbA1c compared with usual care.

    “Evidence for nurse led, digitally enabled programmes, including telemonitoring, app supported education for diabetes self-management and structured messaging, shows feasibility, acceptability and reductions in HbA1c compared with usual care.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [11] Alhaiti, A. (2025). Integrative technologies in nursing-led interventions for diabetes management: A systematic review of efficacy and outcomes. BMC Nurs., 24. source

      Not checked in the free run.

    • cites [41] Kerr, 2024, Digital Interventions for Self-Management of Type 2 Diabetes Mellitus: Systematic Literature Review and Meta-Analysis, J. Med. Internet Res. source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Wearables support physical activity in T2D, but their clinical impact depends on how they are embedded within structured interventions rather than on device sophistication per se.

    “Wearables support physical activity in T2D, but their clinical impact depends on how they are embedded within structured interventions rather than on device sophistication per se.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationcitation

    While wearable devices may still hold value in preventive contexts or in supporting the maintenance of baseline activity among already active individuals, their ability to produce meaningful clinical improvements appears limited in the absence of structured behavioural guidance.

    “While they may still hold value in preventive contexts or in supporting the maintenance of baseline activity among already active individuals, their ability to produce meaningful clinical improvements appears limited in the absence of structured behavioural guidance [26,33].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [26] Chlebowy, 2015, Motivational interviewing to improve diabetes outcomes in African Americans adults with diabetes, West. J. Nurs. Res. source

      Not checked in the free run.

    • cites [33] Matsushita, J., Okada, H., Okada, Y., Sekiyama, T., Iida, H., Shindo, A., Murata, H., and Fukui, M. (2022). Effect of Exercise Instructions With Ambulatory Accelerometer in Japanese Patients With Type 2 Diabetes: A Randomized Control Trial. Front. Endocrinol., 13. source

      Not checked in the free run.

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

    Interpretationreasoning

    Overall, wearables are best viewed as enabling components of comprehensive, structured and supportive care, rather than stand-alone solutions.

    “Overall, wearables are best viewed as enabling components of comprehensive, structured and supportive care, rather than stand-alone solutions.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Across trials of nurse led, digitally enabled programmes, engagement and satisfaction are high, attrition is commonly less than 20 per cent, and improvements in self-care behaviours are consistent.

    “Across trials, engagement and satisfaction are high, attrition is commonly less than 20 per cent, and improvements in self-care behaviours are consistent.”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [11] Alhaiti, A. (2025). Integrative technologies in nursing-led interventions for diabetes management: A systematic review of efficacy and outcomes. BMC Nurs., 24. source

      Not checked in the free run.

    • cites [40] Zhang, 2022, Nurse-led care versus usual care on cardiovascular risk factors for patients with type 2 diabetes: A systematic review and meta-analysis, BMJ Open source

      Not checked in the free run.

    • cites [41] Kerr, 2024, Digital Interventions for Self-Management of Type 2 Diabetes Mellitus: Systematic Literature Review and Meta-Analysis, J. Med. Internet Res. source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    The greatest benefits occur when programmes set clear goals, provide regular monitoring and personalized feedback, and reinforce behaviour change; effects are limited when devices are used in isolation or in loosely organized contexts.

    “The greatest benefits occur when programmes set clear goals, provide regular monitoring and personalized feedback, and reinforce behaviour change; effects are limited when devices are used in isolation or in loosely organized contexts.”
    Quote in the paperSubstantial claim

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

    Study design and conductnone given

    Rapid evolution of technologies, frequent co interventions and differences in device placement or algorithms may complicate attribution of effects to the wearable component alone.

    “In addition, rapid evolution of technologies, frequent co interventions and differences in device placement or algorithms may complicate attribution of effects to the wearable component alone.”
    Quote in the paperNot a substantial claim

  • May combine two claims. The quote only partly states this claim.

    Premisecitation

    Higher contact intensity and tailored content are associated with larger effects in nurse led, digitally enabled programmes.

    “Higher contact intensity and tailored content are associated with larger effects.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [11] Alhaiti, A. (2025). Integrative technologies in nursing-led interventions for diabetes management: A systematic review of efficacy and outcomes. BMC Nurs., 24. source

      Not checked in the free run.

    • cites [41] Kerr, 2024, Digital Interventions for Self-Management of Type 2 Diabetes Mellitus: Systematic Literature Review and Meta-Analysis, J. Med. Internet Res. source

      Not checked in the free run.

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

    Interpretationreasoning

    Nurse-led, multidisciplinary and digitally enabled care pathways, including Lifestyle Medicine case management, offer a pragmatic route to translate monitoring into action and improve intermediate outcomes.

    “Nurse-led, multidisciplinary and digitally enabled care pathways, including Lifestyle Medicine case management, offer a pragmatic route to translate monitoring into action and improve intermediate outcomes.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Asynchronous communication, such as secure messaging, text messages or email, may outperform synchronous calls by enabling near real time prompts at lower logistical cost, provided messages are personalized, behaviour specific and linked to measurable activity or glycaemic targets.

    “Asynchronous communication, such as secure messaging, text messages or email, may outperform synchronous calls by enabling near real time prompts at lower logistical cost, provided messages are personalized, behaviour specific and linked to measurable activity or glycaemic targets [11,41].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [11] Alhaiti, A. (2025). Integrative technologies in nursing-led interventions for diabetes management: A systematic review of efficacy and outcomes. BMC Nurs., 24. source

      Not checked in the free run.

    • cites [41] Kerr, 2024, Digital Interventions for Self-Management of Type 2 Diabetes Mellitus: Systematic Literature Review and Meta-Analysis, J. Med. Internet Res. source

      Not checked in the free run.

76 of 76

  • The paper relies on this without support.

    The actual impact of wearable technologies on adherence to physical activity and key metabolic outcomes in adults with type 2 diabetes is not fully elucidated.

    “However, despite their increasing use in clinical and real-world settings, the actual impact of these diverse technological tools on adherence to physical activity and on key metabolic outcomes in adults with T2D is still not fully elucidated.”
1 of 1

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Previous reviews have generally examined the effects of wearable technologies on broad healthcare outcomes in chronic diseases, the clinical application of smartwatch technologies in diabetes, home-based digital diabetes management, or the effects of wearable technologies on physical activity and metabolic outcomes.

    “Previous reviews have generally examined the effects of wearable technologies on broad healthcare outcomes in chronic diseases, the clinical application of smartwatch technologies in diabetes, home-based digital diabetes management, or the effects of wearable technologies on physical activity and metabolic outcomes (5, 6, 24, 31).”

    From Behavior change pathways by which digital wearable devices support exercise self-management in type 2 diabetes: a scoping review with machine learning–assisted text mining (2026) · cites this paper as [31]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Abstract and main text disagree on the number of included studies

    Minor

    The abstract reports 32 included studies, while the selection account and Results both report 31.

  • A cross-sectional study is cited for an intervention-versus-control result

    Minor

    Study [18] is classified as cross-sectional, yet is cited among studies showing an HbA1c reduction within an intervention group and a significant difference from a control group.

  • A cross-sectional study is cited as showing a post-intervention decrease

    Minor

    Study [16] is classified as cross-sectional, but is also cited as reporting a decrease in sedentary time after an intervention.

3 of 3

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. Kooiman, 2018, Self-tracking of Physical Activity in People With Type 2 Diabetes: A Randomized Controlled Trial, Comput. Inform. Nurs., 36, 340

Cited by

Sorted by citations

Authors
Laffi, A., Persiani, M., Piras, A., Meoni, A., & Raffi, M.
Affiliations
University of Bologna (IT)
Corresponding author
Raffi, Milena
ORCID
Venue
Healthcare
Publisher
MDPI AG
Published
2025-09-24
Volume
13
Issue
19
Pages
2422
ISSN
2227-9032 (ISSN-L)
DOI
10.3390/healthcare13192422
PMC
PMC12524254
OpenAlex
W4414517304
Semantic Scholar
556ca4f08ffa351049db53a6ab219a2bd82f316e
Cited by
9
References
41
Citations by year
2026: 9
FWCI
1.79
Type
journal article
Language
en
Open access
Licence
Locations
  • Healthcare (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion, cc-by)
Funders
  • Erasmus+ (BE-NEW 622371-EPP-1-2020-1-IT-SPO-SCP)
  • Ministero Università e Ricerca PRIN2022 (BE-NEW 622371-EPP-1-2020-1-IT-SPO-SCP)
Topics
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
  • Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Context-Aware Activity Recognition Systems
Keywords
wearable devices, type 2 diabetes, physical activity, physical activity adherence, self-monitoring, metabolic health, step count, blood pressure, lipid profile, HbA1c, body mass index, behavioral interventions, diabetes self-management, supervised exercise intervention

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.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-09.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-09.

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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