Objective: To describe and assess digital health-led diabetes self-management education and support (DSMES) effectiveness in improving glycosylated hemoglobin, diabetes knowledge, and health-related quality of life (HrQoL) of Type 1 and 2 Diabetes in the past 10 years. Design: Systematic Review and Meta-Analysis. The protocol was registered on PROSPERO registration number CRD42019139884. Data Sources: PubMed, EMBASE, Cochrane library, Web of Science, and Scopus between January 2010 and August 2019. Study Selection and Appraisal: Randomized control trials of digital health-led DSMES for Type 1 (T1DM) or 2 (T2DM) diabetes compared to usual care were included. Outcomes were change in HbA1c, diabetes knowledge, and HrQoL. Cochrane Risk of Bias 2.0 tool was used to assess bias and GRADEpro for overall quality. The analysis involved narrative synthesis, subgroup and pooled meta-analyses. Results: From 4286 articles, 39 studies (6861 participants) were included. Mean age was 51.62 years, range (13–70). Meta-analysis revealed intervention effects on HbA1c for T2DM with difference in means (MD) from baseline -0.480% (-0.661, -0.299), I275% (6 months), -0.457% (-0.761, -0.151), I2 81% (12 months), and for T1DM -0.41% (-1.022, 0.208) I2 83% (6 months), -0.03% (-0.210, 0.142) I2 0% (12 months). Few reported HrQoL with Hedges’ g 0.183 (-0.039, 0.405), I2 0% (6 months), 0.153 (-0.060, 0.366), I2 0% (12 months) and diabetes knowledge with Hedges’ g 1.003 (0.068, 1.938), I2 87% (3 months). Conclusion: Digital health-led DSMES are effective in improving HbA1c and diabetes knowledge, notably for T2DM. Research shows non-significant changes in HrQoL. Intervention effect on HbA1c was more impressive if delivered through mobile apps or patient portals. Further research is needed on the impact of DSMES on these outcomes, especially for newly diagnosed diabetes patients.

Original languageEnglish
Article number106370
JournalComputer Methods and Programs in Biomedicine
Publication statusPublished - Oct 2021


  • Diabetes mellitus
  • Diabetes self-management education and support
  • Digital health
  • E-health
  • Global health
  • Health promotion
  • Mobile health
  • Patient Education
  • Social media

ASJC Scopus subject areas

  • Software
  • Computer Science Applications
  • Health Informatics


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