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Cited by 4Mobile Health and mHealth ApplicationsDiabetes Management and EducationDiabetes Management and Research

Digital diabetes management technologies for type 2 diabetes: a systematic review of home-based care interventions

Open access
Abdul Latif el Ejel, Bassel, Sattar, Saba, Fatima, Syeda Bisma, Khan, Hadequa Noor, Ali, Husnain, Iftikhar, Abdullah, Sarwer, Muhammad Asad, Mushtaq, Minahill·2025·Cureus
DOI 10.7759/cureus.84177PMC PMC12168703
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Abstract

Digital diabetes management technologies (DDMTs) have emerged as promising tools for improving glycemic control in patients with type 2 diabetes mellitus (T2DM) receiving home-based care. This systematic review evaluates the effectiveness of various DDMTs, including mobile health applications, continuous glucose monitoring (CGM), telemedicine, smart insulin pens, and artificial intelligence-driven decision support systems, in optimizing blood glucose levels. A comprehensive literature search across PubMed, Embase, Scopus, Web of Science, and the Cochrane Library identified nine high-quality systematic reviews published between 2020 and 2024. These reviews synthesized evidence from randomized controlled trials (RCTs) and observational studies, with sample sizes ranging from small pilot studies to large-scale trials. The findings indicate that DDMTs significantly improve HbA1c levels, fasting blood glucose, and postprandial glucose compared to standard self-care practices. Mobile applications and CGM systems demonstrated notable reductions in HbA1c, while telemedicine interventions enhanced patient adherence and engagement. Personalized coaching and real-time feedback were key factors in intervention success. However, challenges such as digital health literacy, cost barriers, and long-term adherence remain concerns. Some studies highlighted the need for sustained engagement to maintain long-term benefits. While DDMTs offer a viable alternative to traditional diabetes management, future research should focus on standardizing interventions, addressing accessibility issues, and evaluating their cost-effectiveness. This review contributes to the growing evidence supporting DDMTs in T2DM management and underscores the potential of digital health innovations in improving glycemic outcomes and patient self-care in home settings.

AI snapshot

Written from the paper’s full text.

TL;DR

This umbrella/systematic review synthesizes nine reviews published 2020–2024 and concludes that digital diabetes management technologies generally improve glycemic control in home-based type 2 diabetes care, especially HbA1c. Benefits appear strongest when digital tools are combined with personalized coaching and behavior change techniques, but long-term engagement, access, and implementation barriers remain.

Key findings

  • Across included reviews, DDMTs were associated with HbA1c reductions ranging from 0.24% to 0.90%; specific pooled estimates included mHealth apps −0.38% (95% CI −0.50 to −0.25), digital interventions −0.31% (95% CI −0.45 to −0.16), older-adult mHealth −0.24% (95% CI −0.44 to −0.05), mobile app self-care SMD −0.44 (95% CI −0.59 to −0.29), and digital health technologies MD −0.56% for T1DM, −0.90% for T2DM, and −0.26% for prediabetes.
  • Higher-intensity digital interventions with more personalized coaching produced greater HbA1c reductions (−0.45%) than medium-intensity (−0.29%) or low-intensity (−0.28%) interventions.
  • Telemedicine improved HbA1c, fasting glucose, postprandial glucose, systolic blood pressure, and self-efficacy, but benefits may not be sustained beyond 6 months; no significant improvement was found for weight, lipid metabolism, or diabetes awareness.
  • Quality assessment rated 3 included reviews high, 5 moderate, and 1 low using AMSTAR 2.

Methods

  • Design: umbrella review following PRISMA 2020, synthesizing previous systematic reviews and meta-analyses of DDMTs for blood glucose control in home-based T2DM care.
  • Data sources and selection: searched PubMed, Embase, Scopus, Web of Science, and Cochrane Library for English-language studies published January 1, 2020, to January 1, 2025; from 436 records, 73 duplicates removed, 363 title/abstract screened, 17 full texts assessed, and 9 reviews included.
  • Analysis: two independent reviewers screened and extracted data, discrepancies resolved by discussion or a third reviewer; narrative synthesis was used, with AMSTAR 2 for quality assessment.

Limitations

  • The paper states that many included studies had short follow-up periods, variable and sometimes small sample sizes, and heterogeneity in intervention components, outcome measures, and reporting standards, limiting direct comparisons and long-term conclusions.
  • The paper notes remaining concerns about digital health literacy, cost barriers, long-term adherence, data privacy/security, and the need for reimbursement and cost-effectiveness evidence; Zheng et al. found mHealth dietary intervention in T2DM remains mostly in pilot testing with inconclusive effects.
  • Evident from the text: although eligibility excluded T1D, gestational diabetes, and prediabetes, the included reviews sometimes incorporated T1D populations, and only 3 of 9 included reviews were rated high quality, which may limit the strength of the umbrella review’s conclusions.

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

Integrity signals

Registry

Crossref · 10.7759/cureus.84177

Cites

20 of 20 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 22 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Nine high-quality systematic reviews were included.

    “ultimately resulting in the inclusion of nine high-quality reviews”
    Quote in the paperSubstantial claim
  • Findingown data

    Mobile applications demonstrate notable reductions in HbA1c in T2DM home-based care.

    “Mobile applications and CGM systems demonstrated notable reductions in HbA1c”
    Quote in the paperSubstantial claim
  • Findingown data

    DDMTs significantly improve HbA1c levels compared to standard self-care practices in patients with T2DM receiving home-based care.

    “The findings indicate that DDMTs significantly improve HbA1c levels, fasting blood glucose, and postprandial glucose compared to standard self-care practices.”
    Quote in the paperSubstantial claim
  • Findingown data

    Telemedicine interventions enhance patient engagement in T2DM home-based care.

    “telemedicine interventions enhanced patient adherence and engagement”
    Quote in the paperSubstantial claim
  • Findingown data

    DDMTs significantly improve postprandial glucose compared to standard self-care practices in patients with T2DM receiving home-based care.

    “The findings indicate that DDMTs significantly improve HbA1c levels, fasting blood glucose, and postprandial glucose compared to standard self-care practices.”
    Quote in the paperSubstantial claim
  • May combine two claims. 15
  • Classified as probably not a substantial claim. 14
  • The quote only partly states this claim. 3

  • May combine two claims.

    Findingown data

    The included reviews synthesized evidence from 17-54 primary studies, predominantly randomized controlled trials.

    “These reviews synthesized evidence from 17-54 primary studies, predominantly randomized controlled trials (RCTs)”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Sample sizes in the included reviews ranged from 8-17 participants to up to 6,204 participants.

    “with sample sizes ranging from small pilot studies (8-17 participants) to larger trials (up to 6,204 participants across all studies)”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Some included reviews also incorporated T1D populations.

    “though some reviews also incorporated T1D populations”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Methodological quality varied across primary studies, with some reviews noting limitations in study design, intervention duration of three to 12 months, and inconsistent reporting standards.

    “The methodological quality varied across primary studies, with some reviews noting limitations in study design, intervention duration (ranging from three to 12 months), and inconsistent reporting standards”
    Quote in the paperNot a substantial claim

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

    Findingnone given

    Primary outcome measures consistently included HbA1c changes.

    “Primary outcome measures consistently included HbA1c changes”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Studies primarily included adults with T2DM, with mean ages ranging from 42.3 to 65 years.

    “Studies primarily included adults with T2DM, with mean ages ranging from 42.3 to 65 years”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    Most studies reported statistically significant improvements in glycemic outcomes compared to standard care, with HbA1c reductions ranging from 0.24% to 0.90%.

    “Most studies reported statistically significant improvements in glycemic outcomes compared to standard care, with HbA1c reductions ranging from 0.24% to 0.90% [10,15].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [10] Kerr D, Ahn D, Waki K, Wang J, Breznen B, Klonoff DC. Digital interventions for self-management of type 2 diabetes mellitus: systematic literature review and meta-analysis. J Med Internet Res. 2024, 26:e55757. 10.2196/55757 source

      Not checked in the free run.

    • cites [15] Stevens S, Gallagher S, Andrews T, Ashall-Payne L, Humphreys L, Leigh S. The effectiveness of digital health technologies for patients with diabetes mellitus: a systematic review. Front Clin Diabetes Healthc. 2022, 3:936752. 10.3389/fcdhc.2022.936752 source

      Not checked in the free run.

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

    Findingown data

    Secondary outcomes included FBG, PPG, medication adherence, and psychosocial metrics.

    “with secondary outcomes including FBG, PPG, medication adherence, and psychosocial metrics”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Quality assessment showed three included studies were high quality, five moderate, and one low quality.

    “Quality assessment of included articles using the AMSTAR 2 checklist showed that three of the included studies were of high quality, five were of moderate quality, and one was of low quality”
    Quote in the paperNot a substantial claim

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

    Interpretationnone given

    Cost barriers remain a concern for DDMTs.

    “However, challenges such as digital health literacy, cost barriers, and long-term adherence remain concerns.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. The quote only partly states this claim.

    Premisecitation

    Interventions using behavior theory were not statistically different from those that did not (p = 0.18).

    “However, they noted that interventions using behavior theory were not statistically different from those that did not”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [9] El-Gayar O, Ofori M, Nawar N. On the efficacy of behavior change techniques in mHealth for self-management of diabetes: a meta-analysis. J Biomed Inform. 2021, 119:103839. 10.1016/j.jbi.2021.103839 source

      Not checked in the free run.

  • The quote only partly states this claim.

    Premisecitation

    Action planning and self-monitoring of outcome(s) of behavior were the most effective behavior change techniques in mHealth interventions.

    “Using BCTs.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [9] El-Gayar O, Ofori M, Nawar N. On the efficacy of behavior change techniques in mHealth for self-management of diabetes: a meta-analysis. J Biomed Inform. 2021, 119:103839. 10.1016/j.jbi.2021.103839 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Technical issues, uncertainty in readings, and cost may limit CGM uptake.

    “However, technical issues, uncertainty in readings, and cost may limit uptake.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [14] Natale P, Chen S, Chow CK, et al.. Patient experiences of continuous glucose monitoring and sensor-augmented insulin pump therapy for diabetes: a systematic review of qualitative studies. J Diabetes. 2023, 15:1048-69. 10.1111/1753-0407.13454 source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    The search was limited to English-language studies published between January 1, 2020, and January 01, 2025.

    “The search was limited to English-language studies published between January 1, 2020, and January 01, 2025”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    The methodological quality of included systematic reviews was assessed using the AMSTAR 2 checklist.

    “The methodological quality of the included systematic reviews was assessed using the AMSTAR 2 (A MeaSurement Tool to Assess systematic Reviews) checklist.”
    Quote in the paperSubstantial claim

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

    Study design and conductcitation

    The umbrella review adhered to PRISMA 2020 guidelines.

    “This umbrella review adheres to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 guidelines to ensure a systematic and transparent evaluation of existing evidence [8].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [8] Page MJ, McKenzie JE, Bossuyt PM, et al.. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021, 372:n71. 10.1136/bmj.n71 source

      Not checked in the free run.

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

    Study design and conductown data

    Two independent reviewers screened titles and abstracts and then full texts, with discrepancies resolved by discussion or a third reviewer.

    “Two independent reviewers screened the titles and abstracts of retrieved studies, followed by a full-text evaluation of potentially relevant articles. Discrepancies were resolved through discussion or consultation with a third reviewer.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    DDMTs generally demonstrate positive effects on glycemic control, particularly reducing HbA1c.

    “Our findings highlight that DDMTs, including mHealth applications, CGM systems, and telemedicine interventions, generally demonstrate positive effects on glycemic control, particularly in reducing HbA1c levels.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Telemedicine interventions may help patients with T2DM control blood glucose and improve self-management in primary health care.

    “Telemedicine interventions may help patients with T2DM to effectively control BG and improve self-management in primary health care.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [16] Zhang A, Wang J, Wan X, Zhang Z, Zhao S, Guo Z, Wang C. A meta-analysis of the effectiveness of telemedicine in glycemic management among patients with type 2 diabetes in primary care. Int J Environ Res Public Health. 2022, 19:4173. 10.3390/ijerph19074173 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Mobile diabetes apps improved blood sugar levels and most showed significant HbA1c reduction (0.3%-1.3% decrease).

    “Mobile diabetes apps improved blood sugar levels and provided convenient user experience; most apps showed significant HbA1c reduction (0.3%-1.3% decrease in most studies)”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [11] Lee JL, Kim Y. Evaluation of mobile applications for patients with diabetes mellitus: a scoping review. Healthcare (Basel). 2024, 12:368. 10.3390/healthcare12030368 source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    The literature search was conducted across PubMed, Embase, Scopus, Web of Science, and the Cochrane Library.

    “A comprehensive literature search was conducted across major electronic databases, including PubMed, Embase, Scopus, Web of Science, and the Cochrane Library”
    Quote in the paperSubstantial claim

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

    Interpretationnone given

    Digital health literacy remains a concern for DDMTs.

    “However, challenges such as digital health literacy, cost barriers, and long-term adherence remain concerns.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationcitation

    DDMTs can facilitate initial improvements in glycemic control, but maintaining long-term engagement and adherence remains challenging.

    “This temporal pattern suggests that while DDMTs can facilitate initial improvements in glycemic control, maintaining long-term engagement and adherence remains challenging.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Users of DDMTs experienced burden of device complexities and barriers to access, including cost and technological literacy.

    “However, they also experienced the burden of device complexities and barriers to access, including cost and technological literacy.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [14] Natale P, Chen S, Chow CK, et al.. Patient experiences of continuous glucose monitoring and sensor-augmented insulin pump therapy for diabetes: a systematic review of qualitative studies. J Diabetes. 2023, 15:1048-69. 10.1111/1753-0407.13454 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). The quote only partly states this claim.

    Interpretationnone given

    Older adults with T2DM may face unique challenges related to technology adoption.

    “older adults are often underrepresented in digital health research and may face unique challenges related to technology adoption.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductnone given

    Sample sizes varied considerably across studies, with many involving relatively small cohorts, potentially limiting statistical power.

    “Sample sizes varied considerably across studies, with many involving relatively small cohorts, potentially limiting statistical power.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Users of DDMTs reported gaining control and convenience, increased motivation for self-management, and greater confidence in managing their condition.

    “Users reported gaining control and convenience, increased motivation for self-management, and greater confidence in managing their condition.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [14] Natale P, Chen S, Chow CK, et al.. Patient experiences of continuous glucose monitoring and sensor-augmented insulin pump therapy for diabetes: a systematic review of qualitative studies. J Diabetes. 2023, 15:1048-69. 10.1111/1753-0407.13454 source

      Not checked in the free run.

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

    Interpretationnone given

    Challenges related to long-term engagement, technological accessibility, and implementation within healthcare systems remain.

    “However, challenges related to long-term engagement, technological accessibility, and implementation within healthcare systems remain.”
    Quote in the paperSubstantial claim
28 of 28

  • The paper relies on this without support.

    The benefits observed in the included studies are attributable to the DDMTs rather than to other differences between intervention and control groups.

    “Our findings highlight that DDMTs, including mHealth applications, CGM systems, and telemedicine interventions, generally demonstrate positive effects on glycemic control, particularly in reducing HbA1c levels.”

  • The paper relies on this without support.

    The findings from the included systematic reviews are generalizable to home-based T2DM care.

    “This umbrella systematic review provides substantial evidence supporting the effectiveness of DDMTs for improving glycemic control in the home-based management of T2D.”
2 of 2

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?

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.

  • Stevens review has conflicting publication years

    Minor

    Table 1 dates the Stevens review to 2020, while its reference lists publication in 2022.

  • Reported primary-study range excludes an included review

    Minor

    The stated lower bound is 17 primary studies, but Table 1 lists 12 studies for Lee and Kim. Other included reviews also have fewer than 17.

  • Not all nine included reviews were rated high quality

    Minor

    The paper calls all nine included reviews high-quality, but its AMSTAR 2 assessment rates five moderate and one low.

3 of 3

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Authors
Abdul Latif el Ejel, B., Sattar, S., Fatima, S. B., Khan, H. N., Ali, H., Iftikhar, A., Sarwer, M. A., & Mushtaq, M.
Affiliations
  • King Edward Medical University (PK)
  • Abbasi Shaheed Hospital (PK)
  • Karachi Medical and Dental College (PK)
Corresponding author
Sattar, Saba
Venue
Cureus
Publisher
Springer Science and Business Media LLC
Published
2025-05-15
Volume
17
Issue
5
Pages
e84177-e84177
ISSN
2168-8184 (ISSN-L)
DOI
10.7759/cureus.84177
PMC
PMC12168703
OpenAlex
W4410396297
Semantic Scholar
6bed4666121b99d5c4b53d4746fa75400f0706a0
Cited by
4
References
20
Citations by year
2026: 4
FWCI
0.79
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Cureus (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords
type 2 diabetes, home care, glycemic control, HbA1c, continuous glucose monitoring, mobile health apps, telemedicine, smart insulin pens, artificial intelligence decision support, patient adherence, digital health literacy, personalized coaching, real-time feedback

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