Ecological momentary assessment in adolescents with type 1 diabetes mellitus: A scoping review.

Abstract

Aims: To conduct a scoping review of the application of ecological momentary assessment (EMA) in adolescents with type 1 diabetes (T1DM), providing references for future research and practice in this field.

Methods: This review followed the JBI scoping review methodology framework and systematically searched 10 databases, including CNKI, Wanfang, VIP, CBM, PubMed, Web of Science, Cochrane Library, EMbase, PsycINFO and CINAHL, from the establishment of the databases to 29 September 2025. The included literature was summarised and analysed.

Results: Sixteen studies were included. EMA was used to investigate self-management, glycaemic control, psychosocial factors and cognitive function in adolescents with T1DM. Key findings revealed dynamic, real-time associations: self-management behaviours showed time- and context-dependent effects on glycaemic control (e.g. higher risk of omissions in mornings or social situations); affect and glucose levels exhibited bidirectional interactions, with negative affect impairing and positive affect improving glycaemic stability; social environment (peer and family support) and cognitive function (e.g. executive function) significantly moderated management outcomes. Most identified associations were within-person and contemporaneous; few studies examined between-person differences or time-lagged predictive effects. EMA demonstrated acceptable feasibility across diverse protocols. However, considerable methodological heterogeneity existed across studies, and most evidence was limited to Western populations.

Conclusion: EMA is a feasible method for managing type 1 diabetes in adolescents and is capable of capturing real-time, dynamic associations among behaviour, affect, social context and glycaemic control. Future research should prioritise methodological standardisation, develop culturally adapted assessment tools and explore real-time intervention strategies to enable precise and personalised diabetes management. From a clinical perspective, EMA can guide individualised care by identifying high-risk time windows (e.g. mornings), social contexts (e.g. peer dining) and emotional triggers (e.g. negative affect), supporting targeted patient education, just-in-time behavioural reminders and collaborative mental health interventions.