Effects of mobile health interventions on improving glycemic stability and quality of life in patients with type 1 diabetes: A meta-analysis

This meta-analysis aimed to examine the effects of mobile-health-based (mHealth) interventions on improving glycemic stability and quality of life (QOL) in patients with type 1 diabetes (T1D). Various databases, including PubMed, Embase, CINAHL, Cochrane Library, ProQuest, Chinese Electronic Periodical Services, and China Knowledge Resource Integrated, were used to search for relevant articles. A fixed-effects model or random-effects model was used to examine the overall effect. Various methods, including Egger's test, Begg's test, and trim-and-fill, were adopted to examine publication bias. In total, 26 studies were recruited. Results of the random-effects model showed that the use of mHealth-based interventions significantly decreased glycated hemoglobin (HbA1c) (mean difference = −0.37, 95% confidence interval (CI) = −0.53 to −0.22, p <.001), and improved life satisfaction (Hedges' g = 0.30, 95% CI = 0.10 to 0.50, p =.003), worry of diabetes (Hedges' g = −0.25, 95% CI = −0.41 to 0.08, p =.004), and mental health (Hedges' g = 0.36, 95% CI = 0.08 to 0.64, p =.012). Both adults and youths with T1D can benefit from mHealth-based interventions to improve HbA1c (Hedges’ g = −0.44, p =.002 vs. −0.30, p =.003). The effect of mHealth-based interventions on improving QOL in both adults and youths could not be examined due to only one study published in adults with T1D. Moreover, those studies that included the function of feedback from professionals showed a significant effect of decreasing HbA1c compared to those without that function (Hedges' g = −0.48 vs. −0.16, p =.019). Mobile devices are convenient, instantaneous, and easy to use to communicate. Applying mHealth-based interventions with the function of feedback from professionals can be considered an alternative healthcare service to achieve optimal glycemic stability in adults and youths with T1D.