Individualized self-care training systems for type 2 diabetes patients: a systematic review on characteristics of randomized controlled trials (RCTs)

Self-care is crucial for managing chronic diseases like Type 2 diabetes (T2D). Successful self-care is complex and influenced by many factors. Regarding the effectiveness of digital health (DH) systems on T2D self-care behaviors, this research aims to systematically review the characteristics of such systems employed in randomized controlled trial (RCT) studies. Searches of PubMed, Web of Science, Scopus, the Cochrane Library, and Science Direct were conducted from January 2011 to February 2022. The RCTs incorporated in this study provide personalized, tailored self-care training tips for individuals diagnosed with T2D. The National Institute of Health/National Heart, Lung, and Blood Institute tool for controlled intervention studies was used for risk of bias assessment. A total of 26 studies were eligible. M-Health solutions were the most exciting technology for developing T2D self-care DH systems (22/26 studies). Blood glucose monitoring (88.46%), physical activities (76.92%), healthy diet (69.23%), and medication adherence (57.69%) were DH interventions' top self-care priorities. DH systems were mainly used for self-care data collecting (100%), recommendations (96.15%), and monitoring data analysis (84.62%). Educational (100%) and motivational (50%) themes were used for self-care interventions in most trials. We found that DH systems improve the most critical T2D self-care features (BG monitoring, physical exercise, healthy food, and medication adherence). However, more T2D pharmacoadherence trials are needed. This review is relevant for clinicians, self-care training system designers, and researchers interested in using DH solutions to empower T2D patients to manage their self-care.