Laura Suhlrie, Nancy Abdelmalak, Jacob Burns, Hans Hauner, Niels Ole Kristiansen, Anna-Janina Stephan, Michael Laxy
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We synthesized all outcomes graphically via effect directions and conducted meta-analyses for clinical outcomes, including the Risk of Bias 2 Tool. This study was prospectively registered with PROSPERO (CRD42023491693) and OSF (DOI 10.17605/OSF.IO/B89QP). Of 9703 articles, 18 RCTs were included in the systematic review, and 15 RCTs in the meta-analysis. We found statistically significant reductions in body weight (-1.35 kg, 95% CI: [-2.48; -0.23], N = 13 RCTs), body mass index (-0.53 kg/m<sup>2</sup>, 95% CI: [-0.97; -0.09], N = 11 RCTs), and glycated hemoglobin (-0.08%, 95% CI: [-0.10; -0.05], N = 11 RCTs) and point estimates and/or effect directions predominantly suggesting improvements for additional outcomes. Stratified meta-analyses showed no statistically significant between-group differences and missing evidence for long-term effectiveness and equity-relevant subgroups. 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引用次数: 0
摘要
基于智能手机应用程序（app）的干预措施预防2型糖尿病（T2D）越来越多。缺乏对其有效性的全面总结。我们综合了基于app的干预措施对糖尿病前期个体预防T2D的有效性的证据。在这项系统评价和荟萃分析中，我们检索了2013年1月1日至2024年1月31日期间的Web of Science、Embase、Scopus、PubMed Central和Medline，以确定随机对照试验（RCTs），这些试验评估了基于应用程序的干预措施预防针对糖尿病前期个体的T2D的有效性，这些试验以英文发表，对有效性结果没有限制。我们通过效果指示综合了所有结果，并对临床结果进行了荟萃分析，包括风险偏倚2工具。本研究已在PROSPERO （CRD42023491693）和OSF （DOI 10.17605/OSF. io /B89QP）进行前瞻性注册。9703篇文章中，系统评价纳入18篇rct， meta分析纳入15篇rct。我们发现体重（-1.35 kg, 95% CI: [-2.48; -0.23], N = 13个随机对照试验）、体重指数（-0.53 kg/m2, 95% CI: [-0.97; -0.09], N = 11个随机对照试验）和糖化血红蛋白（-0.08%,95% CI: [-0.10; -0.05], N = 11个随机对照试验）和点估计和/或效果方向主要表明其他结局的改善。分层荟萃分析显示，组间差异无统计学意义，缺少长期有效性和公平相关亚组的证据。我们的研究表明，基于应用程序的干预可以改善前驱糖尿病患者的结果（即动机、行为和临床参数）。对临床结果的影响很小。关于公平影响、长期有效性和糖尿病发病率的证据缺失，仍有待调查。
Effectiveness of Smartphone Application-Based Interventions to Prevent Type 2 Diabetes Mellitus in Individuals With Prediabetes: A Systematic Review and Meta-Analysis.
Smartphone application (app)-based interventions to prevent Type 2 diabetes (T2D) are becoming increasingly available. A thorough summary of their effectiveness is lacking. We synthesized evidence on the effectiveness of app-based interventions to prevent T2D targeting individuals with prediabetes. For this systematic review and meta-analysis, we searched Web of Science, Embase, Scopus, PubMed Central, and Medline between January 1, 2013, and January 31, 2024, to identify randomized controlled trials (RCTs) that assessed the effectiveness of app-based interventions to prevent T2D targeting individuals with prediabetes, published in English, without restrictions regarding the effectiveness outcome. We synthesized all outcomes graphically via effect directions and conducted meta-analyses for clinical outcomes, including the Risk of Bias 2 Tool. This study was prospectively registered with PROSPERO (CRD42023491693) and OSF (DOI 10.17605/OSF.IO/B89QP). Of 9703 articles, 18 RCTs were included in the systematic review, and 15 RCTs in the meta-analysis. We found statistically significant reductions in body weight (-1.35 kg, 95% CI: [-2.48; -0.23], N = 13 RCTs), body mass index (-0.53 kg/m2, 95% CI: [-0.97; -0.09], N = 11 RCTs), and glycated hemoglobin (-0.08%, 95% CI: [-0.10; -0.05], N = 11 RCTs) and point estimates and/or effect directions predominantly suggesting improvements for additional outcomes. Stratified meta-analyses showed no statistically significant between-group differences and missing evidence for long-term effectiveness and equity-relevant subgroups. Our study shows that app-based interventions can improve outcomes (i.e., motivation, behavior, and clinical parameters) in individuals with prediabetes. The effect on clinical outcomes is small. Evidence on equity impacts, long-term effectiveness, and diabetes incidence is missing and remains to be investigated.
期刊介绍：
Obesity Reviews is a monthly journal publishing reviews on all disciplines related to obesity and its comorbidities. This includes basic and behavioral sciences, clinical treatment and outcomes, epidemiology, prevention and public health. The journal should, therefore, appeal to all professionals with an interest in obesity and its comorbidities.
Review types may include systematic narrative reviews, quantitative meta-analyses and narrative reviews but all must offer new insights, critical or novel perspectives that will enhance the state of knowledge in the field.
The editorial policy is to publish high quality peer-reviewed manuscripts that provide needed new insight into all aspects of obesity and its related comorbidities while minimizing the period between submission and publication.
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