Digital interventions for self-management of prediabetes: A scoping review

PLoS One. 2024 May 10;19(5):e0303074. doi: 10.1371/journal.pone.0303074. eCollection 2024.

Abstract

Background: Rates of prediabetes, which can lead to type 2 diabetes, are increasing worldwide. Interventions for prediabetes mainly focus on lifestyle changes to diet and exercise. While these interventions are effective, they are often delivered face-to-face, which may pose a barrier to those with limited access to healthcare. Given the evidence for digital interventions addressing other noncommunicable diseases, these may also be effective for prediabetes self-management. The aim of this scoping review was to assess the breadth of evidence around digital interventions for prediabetes self-management.

Methods: We developed a targeted search strategy and relevant studies were identified through searches conducted in four bibliographic databases (Medline, Embase, PsycInfo, and Scopus). Published studies were eligible if they included a digital intervention to support adults aged 18+ with prediabetes self-management. Titles and abstracts were first screened for relevance by one researcher. Full texts of selected records were assessed against the review criteria independently by two researchers for inclusion in the final analysis.

Results: Twenty-nine studies were included, of which nine were randomised controlled trials. Most efficacy studies reported significant changes in at least one primary and/or secondary outcome, including participants' glycaemic control, weight loss and/or physical activity levels. About one-third of studies reported mixed outcomes or early significant outcomes that were not sustained at long-term follow-up. Interventions varied in length, digital modalities, and complexity. Delivery formats included text messages, mobile apps, virtually accessible dietitians/health coaches, online peer groups, and web-based platforms. Approximately half of studies assessed participant engagement/acceptability outcomes.

Conclusion: Whilst the evidence here suggests that digital interventions to support prediabetes self-management are acceptable and have the potential to reduce one's risk of progression to type 2 diabetes, more research is needed to understand which interventions, and which components specifically, have the greatest reach to diverse populations, are most effective at promoting user engagement, and are most effective in the longer term.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Diabetes Mellitus, Type 2 / therapy
  • Exercise
  • Humans
  • Prediabetic State* / therapy
  • Self-Management* / methods
  • Telemedicine / methods

Grants and funding

Funding for this project was received from a project grant from Precision Driven Health. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Melanie Stowell gratefully acknowledges financial support by the Fulbright U.S. Scholar Program, which is sponsored by the U.S. Department of State and New Zealand Fulbright Commission. Its contents are solely the responsibility of the author and do not necessarily represent the official views of the Fulbright Program, the Government of the United States, or the New Zealand Fulbright Commission.