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mHealth Interventions for Disadvantaged and Vulnerable People with Type 2 Diabetes

  • Health Care Delivery Systems and Implementation in Diabetes (ME McDonnell and AR Sadhu, Section Editors)
  • Published:
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Abstract

Background

Mobile- and Internet-delivered (collectively, digital) interventions are widely used by persons with diabetes (PWD) to assist with self-management and improve/maintain glycemic control (hemoglobin A1c [A1c]). However, evidence concerning the acceptance and benefits of such interventions among disadvantaged/vulnerable PWD is still quite limited.

Purpose of Review

We reviewed studies published from 2011–April 2019 evaluating the impact of diabetes self-management interventions delivered via mobile device and/or Internet on glycemic control of disadvantaged/vulnerable adults with type 2 diabetes (T2D). Included studies reported ≥ 50% of the sample having a low socioeconomic status and/or being a racial/ethnic minority, or living in a rural setting or low-/middle-income country (LMIC). We identified 21 studies evaluating a digital intervention among disadvantaged/vulnerable PWD.

Recent Findings

Although many digital interventions found within-group A1c improvements (16 of 21 studies), only seven of the seventeen studies with a control group found between-group differences in A1c. Three studies found reductions in emergency room (ER) visits and hospitalizations. We synthesize this information, and provide recommendations for increasing access, and improving the design and usability of such interventions. We also discuss the role of human support in digital delivery, issues related to study design, reporting, economic value, and available research in LMICs.

Summary

There is evidence suggesting that digital interventions can improve diabetes control, healthcare utilization, and healthcare costs. More research is needed to substantiate these early findings, and many issues remain in order to optimize the impact of digital interventions on the health outcomes of disadvantaged/vulnerable persons with diabetes.

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Acknowledgments

The authors would like Dr. Lyndsay Nelson and Mr. Taylor Coston for their assistance with conducting the search and screening articles.

Funding

Dr. Mayberry is supported by K01DK106306 and R01DK100694 from the National Institute of Diabetes and Digestive and Kidney Diseases. Dr. Lyles was supported by R00HS022408 and R01HS025429 from the Agency of Healthcare Research and Quality. Dr. Peek’s effort was supported by the Chicago Center for Diabetes Translation Research (NIDDK P30DK09294).

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Authors and Affiliations

  1. Vanderbilt University Medical Center, Nashville, TN, USA

    Lindsay Satterwhite Mayberry & Makenzie Parks

  2. University of California, San Francisco, USA

    Courtney R. Lyles

  3. The University of Melbourne, Victoria, Australia

    Brian Oldenburg

  4. Lirio, Nashville, TN, USA

    Chandra Y. Osborn

  5. Section of General Internal Medicine, Chicago Center for Diabetes Translation Research, The University of Chicago, 5841 S. Maryland Avenue, MC 2007, Chicago, IL, 60637, USA

    Monica E. Peek

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  1. Lindsay Satterwhite Mayberry
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  2. Courtney R. Lyles
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  3. Brian Oldenburg
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  4. Chandra Y. Osborn
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  5. Makenzie Parks
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  6. Monica E. Peek
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Correspondence to Monica E. Peek.

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This article is part of the Topical Collection on Health Care Delivery Systems and Implementation in Diabetes

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Mayberry, L.S., Lyles, C.R., Oldenburg, B. et al. mHealth Interventions for Disadvantaged and Vulnerable People with Type 2 Diabetes. Curr Diab Rep 19, 148 (2019). https://doi.org/10.1007/s11892-019-1280-9

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