Electronic interventions offer short-lived impact on diabetics

Self-management interventions delivered by computer and mobile phone currently provide limited benefits for people with diabetes, according to a systematic review published in The Cochrane Library. Although computer and mobile phone-based self-management programs had small positive effects on blood sugar levels, these effects seemed to be short-lived.

The researchers reviewed data from 16 trials involving a total of 3,578 people with type 2 diabetes, who used computers or mobile phones as part of diabetes self-management interventions for between 1 and 12 months. Overall, these interventions appeared to be safe but had limited positive effects. There were small benefits for controlling blood sugar levels, with slightly greater benefits for those whose self-care programs were delivered by mobile phones. However, the benefits waned after six months and there was no evidence that these interventions helped to improve depression, quality of life or weight in people with type 2 diabetes.

"Our review shows that although popular, computer-based diabetes self-management interventions currently have limited evidence supporting their use," said lead researcher, Kingshuk Pal of the Research Department of Primary Care and Population Health at UCL in London. "There are also few studies looking at cost effectiveness or long-term impact on patient health."

The authors saw some evidence of computer-based interventions helping to improve knowledge and understanding of diabetes, but this did not seem to translate into behaviors that could improve health, such as changes in diet and exercise. "Effective self-management is a complex task that may require changes to many aspects of people's lives. Any intervention to help that process needs to support sustained behavior change in different areas like eating habits, physical activity or taking medication regularly and provide emotional support," said Pal. "We did not see any convincing evidence for long-term change like this in the interventions we looked at."