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Smartphone Apps That Promote Lifestyle Changes Could Help Prevent Type 2 Diabetes

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Smartphone application interventions that support lifestyle behavior changes may help prevent type 2 diabetes in high-risk populations, according to data published in the American Journal of Preventative Medicine.1

Nearly 1 in 10 people in the United States have diabetes, with 90% to 95% of cases being type 2 diabetes.2 Modifiable lifestyle factors, including unhealthy eating habits and sedentary lifestyles, are linked to a higher risk of developing the condition. Lifestyle interventions encouraging eating a healthier diet and being more physically active have become popular to promote weight loss and reduce type 2 diabetes risk.

“Smartphone [apps] have emerged as effective tools to promote lifestyle changes and support health behavior modifications in both healthy individuals and clinical populations,” the authors wrote. “However, evidence supporting the use of apps for lifestyle behavior change and diabetes prevention in pre-diabetes populations is lacking.”

Investigators conducted a systematic review and meta-analysis to examine the acceptability and effectiveness of smartphone apps for the prevention of type 2 diabetes. Databases searched for the study included PubMed, Embase, CINAHL, and PsychInfo. A total of 24 studies, consisting of 2378 participants, that were conducted between 2008 and 2023 were included in the review.

The included randomized controlled trials involved adults at a high risk of developing diabetes who evaluated an app aiming to prevent type 2 diabetes with an average duration of 6 months. Random-effects meta-analyses were conducted for weight loss, body mass index (BMI), glycated hemoglobin, and waist circumference.

Investigators found that smartphone apps were effective at promoting weight loss and reducing BMI. However, there was no evidence that apps had an impact on either HbA1c levels or waist circumference. Apps that had higher levels of user engagement were shown to have a greater effectiveness in achieving weight loss.

Key app factors that participants said they preferred and influenced higher levels of engagement included the level of personalization, automated progress tracking, and inclusion of social networking features.

Study limitations include that the search strategy was not peer-reviewed, that data extraction was not conducted independently, that the criterion for including people at high risk of developing type 2 diabetes was based on the definitions provided by the authors, and that the meta-analysis included a range of comparators.

“This review suggests the value of smartphone apps in modifying risk factors for type 2 diabetes in high-risk populations, but impact on incidence of type 2 diabetes and reduction in HbA1C was not seen and requires further study, with longer duration follow-up and higher diversity in included participants,” the authors wrote. “Future robust trials should explore the role of AI in further personalizing interventions for higher engagement and effectiveness.”

References
1. Jahan E, Almansour R, Ijaz K, et al. Smartphone applications to prevent type 2 diabetes: A systematic review and meta-analysis. Am J Prev Med. Published online January 2024. doi:10.1016/j.amepre.2024.01.008
2. Type 2 Diabetes. Report. CDC. April 18, 2023. Accessed January 26, 2024. https://www.cdc.gov/diabetes/basics/type2.html

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