Opportunities and Threats of Electronic Health in Management of Diabetes Mellitus: An Umbrella Review of Systematic Review and Meta-Analysis Studies

Abstract

To determine the role of electronic health (e-health) in the management of diabetes mellitus (DM), systematic review (SR) and meta-analysis (MA) studies were searched systematically. Eleven SR and six MA studies, including 533 sub-articles, were finally assessed. Six articles studied type 2, two studies assessed type 1, and five studies focused on both types of DM while four studies included type 1, type 2, and gestational DM. In total, 38641 patients with DM from all age groups were studied with a follow-up time from two phone calls to 60 months. As an intervention, short message service, multimedia messaging service, telemonitoring, glucometer applications, and personal digital assistant tools were studied. Nine out of 17 studies (53%) showed a significant reduction in HbA1c and eight (47%) studies revealed the inconclusive effect on it. However, the first group of studies was stronger and among interventions, text messaging as reminders was more effective. Conclusively, the majority of evidence shows the improvement of DM management by using e-health. However, a fragile acceptance toward this issue existed. Therefore, future research should focus more on using standard tools for the assessment of e-health efficacy, patients’ views, health care providers’ opinions, and cost-effectiveness of such interventions in long term.