JMIR Publications

ABSTRACT

Background:

Digital technology can improve diabetes treatment and management. However, the effectiveness of using digital education interventions in improving the glycaemic control of children and young people is unknown.

Objective:

To explore the evidence-based literature on the effectiveness of digital educational interventions in children and young people living with diabetes. The review aimed to identify online resources and technology and synthesise the effect size of interventions on glycated haemoglobin (HbA1c), in addition to other outcome measures used to assess the efficacy of the intervention.

Methods:

A systematic review and meta-analysis were conducted using the Joanna Briggs Institute (JBI) Methodology. A database search was completed using MEDLINE, CINAHL, Cochrane Library, Embase, ClinicalTrials.gov website, the International Clinical Trials Registry Platform, and ProQuest Dissertations. Only studies published in English and published during the last 20 years were included. An a priori protocol was developed and made available on the Open Science Framework and was registered in PROSPERO (CRD42024599125).

Results:

A total of 14 studies, comprising 1330 participants from 9 countries, were included. A statistically significant reduction in HbA1c levels in children and young people diagnosed with type 1 diabetes was found (MD= ꟷ0.17, 95% CIꟷ 0.29,ꟷ0.05, P = 0.006, I2 = 38%). The use of telemedicine platforms, including the transmission of blood glucose data with feedback or wearable devices, was the most common platform and form of data collection. In the subgroup analysis, the fixed effects model showed positive outcomes for diabetes related worry (MD = 2.59, 95% CI 0.77, 4.42, P = .005, I2 = 87%) and treatment satisfaction (MD= 1.92, 95% CI 0.78, 3.05, P = .001, I2 = 0%), favouring the use of 'digital educational interventions. Subgroup analyses included the duration of interventions as well as the types and content of digital educational interventions. However, the effect of these interventions according to age group and digital platform remains uncertain.

Conclusions:

Engagement with interventions using 'digital educational interventions' demonstrated improved HbA1c levels in children and young people with diabetes. Since we were unable to locate studies among children and young people with type 2 diabetes or prediabetes, our findings are limited to type 1 diabetes. Establishing guidelines for the design of digitally interactive interventions informed by motivational theory, the inclusion of longer follow-up times, the inclusion of low- and middle-income countries and the development of interventions for culturally and linguistically diverse populations would improve study quality, consistency of reporting and development in this emerging field.