Effectiveness of wearable technology-based physical activity interventions for adults with type 2 diabetes mellitus: A systematic review and meta-regression

Abstract

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder with the increasing prevalence of a modern sedentary lifestyle. Wearable technology-based physical activity interventions (WT-BPAI) might provide a channel to improve diabetic self-management. The study aimed to (1) evaluate the effectiveness of WT-BPAI on PA levels, glycemic levels, and other outcomes (blood pressure [BP], body mass index [BMI], and serum lipid profile) in adults with T2DM, and (2) investigate the potential covariates affecting aforementioned outcomes. Eight databases were searched thoroughly using three steps from inception until January 16, 2024. The quality of the studies and overall evidence were evaluated. The package meta of the R software program version 4.3.1. was utilized for meta-analyses, subgroup analyses, and meta-regression analyses. A total of 19 randomized controlled trials (RCTs) were found. Meta-analyses revealed that WT-BPAI significantly increased 1583 steps per day and decreased systolic BP (SBP) by 2.46 mmHg. Subgroup and meta-regression analyses found that function, duration of intervention, and age were significant covariates. According to the risk of bias version 2, more than half of the trials raised some concerns about the randomization process, deviations from the intended intervention, and missing outcome data. The certainty of the evidence was very low for all outcomes based on the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. WT-BPAI can be considered a supplementary intervention to increase the steps per day and decrease SBP, especially when used for short periods in young adults with T2DM. However, we need more well-designed research with long-term outcomes.

Keywords: meta‐analysis; meta‐regression; physical activity interventions; type 2 diabetes mellitus; wearable technology.

FIGURE 1

Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) flow diagram of study selection. CINAHL, Cumulative Index of Nursing and Allied Health Literature, and IEEE, Institute of Electrical and Electronics Engineers Xplore digtial library.

FIGURE 2

Forest plot of mean difference in glycated hemoglobin (HbA1c) for wearable technology‐based physical activity interventions and comparators. CI, confidence interval; MD, mean difference; SD, standard deviation.

FIGURE 3

Forest plot of mean difference in step count (steps per day) for wearable technology‐based physical activity interventions and comparators. CI, confidence interval; MD, mean difference; SD, standard deviation.