Online diabetes self-management education application for reducing glycated hemoglobin level among patients with type ۱ diabetes mellitus: a systematic review and metaanalysis

Background: This meta-analysis study aims to evaluate the Diabetes Self-Management Education and Support (DSMES) online application for reducing glycated hemoglobin levels among patients with type ۱ diabetes mellitus (T۱DM) patients. Main text: The Web of Science (WoS), Cochrane Library, PubMed, Scopus, PROSPERO, and EMBASE databases were searched with Medical Subject Headings (MeSH) terms without minimum time limitation until February ۲۰۲۴. To be eligible, all the following predefined inclusion criteria must have been met in the original randomized controlled trial (RCT) studies without language limitation including T۱DM, patients, online digital interventions such as web-based, mobile health applications, or e-health, ۳ or more months follow-up, and measuring HbA۱c. Finally, ۱۰ studies were conducted, ۱۱۹۵ T۱DM patients were included in this study of which ۴۲۱ (۳۵.۲%) were adults and ۷۷۴ (۶۴.۸%) were adolescents. Overall, the mean differences for HbA۱c at ۶ months between baseline and follow-up groups was ۰.۲۷% (-۰.۷۶, ۱.۳۱) (P < ۰.۰۰۱) in adolescents and ۰.۹۲% (۰.۳۴, ۱.۵) (P < ۰.۰۰۱) in adults. Moreover, the mean differences for HbA۱c at ۱۲ months between baseline and follow-up groups was -۰.۰۲% (-۰.۳۱, ۰.۲۶) (P = ۰.۸۵) in adults. Conclusions: This meta-analysis provides robust evidence that online DSMES applications are effective in HbA۱c levels among patients with T۱DM, particularly in adults and adolescents. The findings suggest that online DSMES interventions can lead to significant improvements in glycemic control, with a mean difference in HbA۱c levels of ۰.۲۷% at ۶ months in adolescents and ۰.۹۲% in adults. Notably, the effect persisted at ۱۲ months in adults, with a mean difference of -۰.۰۲%. These results have important implications for clinical practice, suggesting that online DSMES can be a valuable adjunct to traditional diabetes management strategies

کلیدواژه ها:

Diabetes mellitus ، Type ۱ ، Diabetes self-management education ، Hemoglobin A۱c