JMIR Publications

ABSTRACT

Background:

Online health information seeking (OHIS) has become a central component of chronic disease management within an increasingly interactive and algorithm-mediated digital ecosystem. For individuals with diabetes, ongoing self-management demands create sustained needs for accessible and actionable health information. Although prior reviews have described general information-seeking behaviors, few have integrated technological evolution, multilevel determinants, and equity considerations specific to diabetes.

Objective:

This scoping review aimed to map patterns of OHIS among individuals with diabetes, identify the types of information sought, synthesize multilevel determinants of OHIS, and explore temporal shifts across major phases of digital health development.

Methods:

This scoping review was conducted in accordance with the PRISMA-ScR and PRISMA-S reporting guidelines and was guided by the Sample, Phenomenon of Interest, Design, Evaluation, Research type framework. Five electronic databases, PubMed, Scopus, Web of Science, CINAHL, and Embase were systematically searched for English-language empirical studies from inception through May 4, 2026. Eligible studies included empirical research investigating OHIS behaviors among individuals with type 1 diabetes, type 2 diabetes, or gestational diabetes. Data were extracted using a standardized charting form and synthesized descriptively. Determinants were organized according to the Social Ecological Model, and qualitative findings were analyzed using content analysis. Studies were stratified into three periods reflecting shifts in digital infrastructure: early web environments from 2002 to 2010, expansion of social media and mobile technologies from 2011 to 2018, and integrated digital and artificial intelligence (AI)-enabled ecosystems from 2019 to 2026.

Results:

Eighty-one studies from 32 countries met the inclusion criteria. Use of digital sources diversified over time. Early studies emphasized search engines and institutional websites, whereas later studies increasingly reported engagement with social media platforms and online communities. Mobile health applications and generative AI chatbots appeared in recent publications, although evidence on AI use remained limited. The most frequently sought content included self-management and lifestyle guidance, general diabetes knowledge, and treatment-related information. Determinants of OHIS operated across multiple levels. At the individual level, younger age, greater educational attainment, higher income, and better eHealth literacy were associated with increased engagement, while psychological factors such as perceived knowledge gaps and desire for autonomy motivated searching. Interpersonal influences included peer support and clinician communication. Organizational and environmental factors encompassed healthcare access, digital infrastructure, information quality, and platform characteristics. Persistent disparities were observed among older adults and socioeconomically disadvantaged groups.

Conclusions:

This review conceptualizes OHIS as a dynamic process shaped by technological evolution, multilevel determinants, and equity considerations, extending beyond prior platform-focused syntheses. By capturing the shift toward socially mediated and AI-enabled ecosystems, it offers a temporally informed understanding of digital influences on patient engagement and decision-making. Persistent disparities underscore the need to integrate digital-health discussions into care and strengthen eHealth literacy to support equitable diabetes management.