# Effectiveness of Smartphone Application‐Based Interventions to Prevent Type 2 Diabetes Mellitus in Individuals With Prediabetes: A Systematic Review and Meta‐Analysis

## TL;DR

Smartphone apps can help prevent Type 2 diabetes in prediabetic individuals, but their long-term effectiveness and impact on equity remain unclear.

## Contribution

This study provides a systematic review and meta-analysis of app-based interventions for T2D prevention in prediabetic individuals.

## Key findings

- App-based interventions significantly reduced body weight and BMI in prediabetic individuals.
- Small reductions in glycated hemoglobin levels were observed.
- Long-term effectiveness and equity impacts remain understudied.

## Abstract

Smartphone application (app)‐based interventions to prevent Type 2 diabetes (T2D) are becoming increasingly available. A thorough summary of their effectiveness is lacking. We synthesized evidence on the effectiveness of app‐based interventions to prevent T2D targeting individuals with prediabetes. For this systematic review and meta‐analysis, we searched Web of Science, Embase, Scopus, PubMed Central, and Medline between January 1, 2013, and January 31, 2024, to identify randomized controlled trials (RCTs) that assessed the effectiveness of app‐based interventions to prevent T2D targeting individuals with prediabetes, published in English, without restrictions regarding the effectiveness outcome. We synthesized all outcomes graphically via effect directions and conducted meta‐analyses for clinical outcomes, including the Risk of Bias 2 Tool. This study was prospectively registered with PROSPERO (CRD42023491693) and OSF (DOI 10.17605/OSF.IO/B89QP). Of 9703 articles, 18 RCTs were included in the systematic review, and 15 RCTs in the meta‐analysis. We found statistically significant reductions in body weight (−1.35 kg, 95% CI: [−2.48; −0.23], N = 13 RCTs), body mass index (−0.53 kg/m2, 95% CI: [−0.97; −0.09], N = 11 RCTs), and glycated hemoglobin (−0.08%, 95% CI: [−0.10; −0.05], N = 11 RCTs) and point estimates and/or effect directions predominantly suggesting improvements for additional outcomes. Stratified meta‐analyses showed no statistically significant between‐group differences and missing evidence for long‐term effectiveness and equity‐relevant subgroups. Our study shows that app‐based interventions can improve outcomes (i.e., motivation, behavior, and clinical parameters) in individuals with prediabetes. The effect on clinical outcomes is small. Evidence on equity impacts, long‐term effectiveness, and diabetes incidence is missing and remains to be investigated.