Smartphones and Apps to Control Glycosylated Hemoglobin (HbA1c) Level in Diabetes: A Systematic Review and Meta-Analysis

Introduction: Diabetes mellitus is a chronic endocrine-metabolic disease, the evolution of which is closely related to people's self-control of glycemic levels through nutrition, exercise, and medicines. Aim: To determine whether smartphone apps can help persons with diabetes to improve their % levels of glycosylated hemoglobin. Method: A systematic review and meta-analysis were done. ProQuest, Pubmed/Medline, and Scopus databases were used. The search equation used was (Prevention and Control) AND Diabetes Mellitus AND Smartphones. The inclusion criteria applied were clinical trials, conducted in 2014-2019. Results: n = 18 studies were included in the review. The studies tried different applications to monitor glycemia and support patients to improve glycosylated hemoglobin (HbA1c) levels. More than half of the studies found statistically significant differences in HbA1c in the intervention group compared with the control group. Eleven studies were included in the meta-analysis and the study sample was n = 545 for the experimental group and n = 454 for the control group. The meta-analytic estimation of the HbA1c % level means differences between intervention and control group was statistically significant in favour of the intervention group with a mean difference of -0.37 (-0.58, -0.15. 95% confidence interval). Conclusion: Smartphone apps can help people with diabetes to improve their level of HbA1c, but the clinical impact is low.