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Digital Healthcare

The impact of online self-management interventions on midlife adults with type 2 diabetes: a systematic review

12 March 2020

Focus

02 March 2020

Volume 29 · Issue 5

ISSN (print): 0966-0461

ISSN (online): 2052-2819

Abstract

Background:

Online self-management education programmes are now recommended for people with type 2 diabetes to improve self-management capacities. There is limited evidence to determine whether such programmes improve the health outcomes for midlife adults with diabetes.

Aims:

The purpose of this systematic review was to assess the impact of online self-management interventions with digital consulting on glycated haemoglobin (HbA1c), total cholesterol, blood pressure, diabetes distress, self-efficacy, and depression in midlife adults.

Methods:

A systematic review was undertaken searching Medline, Embase and CINAHL. Studies were appraised using the Cochrane Collaboration's tool.

Results:

Eight studies were included. Online interventions resulted in the improvement of HbA1c (pooled mean difference on HbA1c: -0.35%, 95% CI (-0.52, -0.18), P<0.001). A narrative synthesis was conducted for all secondary outcomes. No conclusions could be drawn on the impact of these outcomes.

Conclusion:

Online interventions improve HbA1c. Further research is needed for secondary outcomes.

The prevalence of diabetes is rapidly rising around the world, especially in low- and middle-income countries (Ogurtsova et al, 2017; World Health Organization, 2018). In 2015 it was estimated that, globally, nearly 415 million people were living with diabetes (Ogurtsova et al, 2017). Type 2 diabetes accounts for 90% of cases (Bruno et al, 2005; Holman et al, 2015; Zheng et al, 2018).

The growing prevalence and incidence of type 2 diabetes, coupled with its costly complications, impose a significant burden on health services. It is predicted that about 12% of global health expenditure is dedicated to the health-related costs of the condition (Ogurtsova et al, 2017). In the UK, the cost of type 2 diabetes to the NHS has been estimated to be about 10% of the NHS budget (£8.8 billion), of which approximately 80% (£7.7 billion) is spent on associated complications (Diabetes UK, 2014).

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Type 2 diabetes

Patient self-management

Online education programmes

Glycated haemoglobin

HbA1c