Digital health applications are becoming increasingly important in the prevention of type 2 diabetes. A new systematic review and meta-analysis by the Professorship of Public Health and Prevention of Prof. Dr. Michael Laxy provides the first comprehensive summary of the effectiveness of app-based interventions in people with prediabetes. The study was published in the journal “Obesity Reviews,” which has an impact factor of 7.4.
Around ten percent of adults worldwide are affected by diabetes. Around 90 percent of them have type 2 diabetes. Early prevention is crucial. And smartphone apps promise to make this accessible and cost-effective. But how effective are such digital programs really? To answer this question, the research team analyzed 18 randomized controlled trials with a total of over 6,000 participants. In 15 of these studies, the authors of the Professorship of Public Health and Prevention were also able to perform statistical meta-analyses. The result: app-based interventions led to statistically significant, albeit moderate, improvements in clinical indicators.
There was an average weight loss of 1.35 kilograms, a decrease in body mass index (BMI) of 0.53 kg/m², and a reduction in long-term blood sugar of 0.08 percent. In addition, positive trends in motivation, self-efficacy, and healthy eating habits were observed.
“Digital health applications have enormous potential – but we need to better understand how effective they actually are,” explains Laura Suhlrie, Research Associate and first author of the study. “Our goal was to systematically evaluate the existing evidence on the effectiveness of app-based interventions.”
“The results show that the smartphone apps analyzed so far in the studies can positively influence health behavior and metabolic parameters – albeit to a rather moderate extent,” adds Dr. Anna-Janina Stephan, a Research Associate at the Professorship of Public Health and Prevention and co-supervisor of the study.
The analysis showed that the strongest effects occurred within the first six months. After that, the improvements weakened, which could indicate a decline in use or motivation. Only a few studies followed participants over longer periods of time.
“The data available so far is not sufficient to reliably assess the long-term benefits of these apps,” emphasizes Nancy Abdelmalak, also a Research Associate at the Professorship of Public Health and Prevention and co-author. “We need more high-quality studies with longer follow-up periods to understand whether the positive effects are sustainable – and which target groups benefit most.”
In addition, there has been a lack of data on possible differences between age, education, and income groups. It therefore remains unclear whether digital prevention services reduce or rather exacerbate social health inequalities. “A key issue is the question of equity: the analyzed studies do not allow reliable conclusions about which population groups smartphone apps are particularly effective or less effective for. Regardless of this, individuals with low socioeconomic status have potentially less access to digital devices – and thus also to digital health services. This should be taken into consideration in health policy decision making,” says Abdelmalak.
It was also interesting to note that interventions with additional face-to-face components – such as personal consultations or group sessions – tended to have stronger effects. The researchers conclude that digital programs are most effective when combined with personal support.
“App-based interventions are fundamentally much more scalable than many traditional in-person programs. However, whether they – like some in-person programs – can reduce the long-term risk of type 2 diabetes remains unclear and requires further research,” says Prof. Laxy. “Developments in this field are, however, very dynamic. It is conceivable that future advancements – such as the integration of sensor technology or hybrid approaches that combine digital applications with personal coaching – could significantly improve the effectiveness of such interventions.”
With their work, the TUM team provides a solid scientific basis for the evaluation and further development of digital diabetes prevention programs. This is a highly topical issue in view of the increasing digitalization of the healthcare system and the introduction of digital health applications in Germany.
“Our findings support political and health decision-makers in making informed decisions to promote digital prevention services,” says Abdelmalak. “At the same time, they clearly show where research gaps still exist—particularly with regard to long-term effectiveness and equal health opportunities.”
The authors recommend future studies that shed more light on the long-term effects, cost-benefit aspects, and social dimensions of digital prevention. They emphasize that small individual effects could still have a relevant impact if applied on a broad scale.
“If we manage to use these tools in a targeted, evidence-based, and equitable manner, digital interventions can become an important building block of public health promotion,” concludes Suhlrie.
To the publication „Effectiveness of smartphone application-based interventions to prevent type 2 diabetes mellitus in individuals with prediabetes: A systematic review and meta-analysis” in the journal „Obesity Reviews”
To the homepage of the Professorship of Public Health and Prevention
Contact:
Prof. Dr. Michael Laxy
Professorship of Public Health and Prevention
Am Olympiacampus 11
80809 München
phone: 089 289 24977
e-mail: michael.laxy(at)tum.de
Laura Suhlrie
Professorship of Public Health and Prevention
Am Olympiacampus 11
80809 München
phone: 089 289 24995
e-mail: laura.suhlrie(at)tum.de
Nancy Abdelmalak
Professorship of Public Health and Prevention
Am Olympiacampus 11
80809 München
phone: 089 289 29764
e-mail: nancy.abdelmalak(at)tum.de
Text: Romy Schwaiger
Photos: „Obesity Reviews”/Astrid Eckert, TUM/private