Table 4.
Application category and type of diabetes | Feedback characteristics | Trials, n | Patients, n | Outcome | MDa (95% CI) of percent change in HbA1c | P value | I2 (%) | Grading of Recommendations, Assessment, Development, and Evaluation | |
Telemedicine [70,82] | |||||||||
|
T1Db | App based | 5 | 336 | c | −0.37 (−0.94 to 0.20) | .20 | 81.74 | |
|
T1D | High intensityd | 13 | NS | c | −0.24 (−0.49 to 0.01) | NSe | NS | |
|
T1D | ≠ High intensity | 14 | NS | c | −0.09 (−0.23 to 0.06) | NS | NS | |
|
T1D | Audit + feedback | 24 | NS | c | −0.22 (−0.38 to −0.06) | NS | NS | |
|
T1D | No audit + feedback | 4 | NS | c | 0.01 (−0.27 to −0.30) | NS | NS | |
Digital self-management [59,68,72,81,83] | |||||||||
|
T2Df | Human call/telephone | 5 | NS | c,g | −1.13 (−1.51 to −0.75) | <.05 | 38 | |
|
T2D | Human call/telephone | 12 | NS | c,g | −0.53 (−0.81 to −0.26) | <.001 | 76.35 | |
|
T2D | Manual | 6 | 1180 | c,g | −0.44 (−0.74 to −0.15) | .04 | NS | |
|
T2D | Manual | 22 | NS | c,g | −0.50 (−0.65 to −0.34) | <.001 | 67.2 | |
|
T2D | Automated | 5 | NS | c,g | −0.50 (−0.69 to −0.32) | <.001 | 0 | |
|
T2D | Automated calls | 2 | NS | c | −0.01 (−0.32 to 0.29) | .94 | 0 | |
|
T2D | Automated text | 9 | NS | c | −0.36 (−0.47 to −0.24) | NS | 0 | |
|
T2D | Text message | 3 | 380 | c,g | −0.52 (−1.04 to 0.00) | <.05 | 73.5 | |
|
T2D | Web-based | 13 | 2405 | c,g | −0.41 (−0.55 to −0.27) | <.05 | 79.6 | |
|
T2D | Web-based | 19 | NS | c,g | −0.62 (−0.82 to −0.42) | <.001 | 77.57 | |
Digital self-management (mobile health) [63,82,84] | |||||||||
|
T2D | Low frequency | 7 | 440 | c,g | −0.33 (−0.59 to −0.07) | .01 | 47.35 | |
|
T2D | High frequency | 5 | 326 | c,g | −1.12 (−1.32 to −0.91) | <.001 | 0 | |
|
T1D/T2D | Personalized feedback | 8 | NS | c,g | −0.43 (−0.74 to −0.12) | <.001 | 75 | |
|
T1D/T2D | ≠ Personalized feedback | 4 | NS | c,g | −0.61 (−1.40 to 0.19) | .001 | 81 | |
|
T1D/T2D | Frequency (daily) | 15 | NS | c | −0.6 (−0.9 to −0.4) | .27 | NS | |
|
T1D/T2D | Frequency (weekly) | 3 | NS | c | −0.2 (−0.6 to 0.2) | .27 | NS | |
|
T1D/T2D | Frequency (not specified) | 4 | NS | c | −0.4 (−0.5 to −0.2) | .27 | NS |
aMD: mean difference.
bT1D: type 1 diabetes.
cThe direction of the arrows indicates potential clinically relevant reduction rates (see Table 2).
dDirect contact at least once a week.
eNS: not specified—cases in which no data were provided. Missing data on statistical significance were handled as nonsignificant.
fT2D: type 2 diabetes.
gGreen arrows show statistical significance.