Effect of Digital Health Interventions in Diabetic Distress Among Type-2 Diabetes Mellitus Patients: A Systematic Review and Meta-Analysis

Abstract

Background: Diabetes distress is a common psychological burden among individuals with type 2 diabetes mellitus (T2DM) and adversely affects self-management, treatment adherence, and health outcomes. Digital health interventions have emerged as promising tools to support diabetes care; however, their effectiveness in reducing diabetes distress remains uncertain. Purpose: To evaluate the effectiveness of digital health interventions in reducing diabetes distress among adults with T2DM. Methods: A systematic review and meta-analysis of randomised controlled trials (RCTs) was conducted following PRISMA guidelines and registered in PROSPERO (CRD42025115598). PubMed/MEDLINE, Scopus, and Embase were searched from 2010 to September 2025. Studies evaluating digital health interventions, including mobile health applications, telemedicine, web-based platforms, SMS-based programs, and digital behavioral support tools, were included. Pooled mean differences (MDs) and 95% confidence intervals (CIs) were calculated using a random-effects model. Results: Twelve RCTs involving 3,147 participants were included. The pooled analysis showed no statistically significant reduction in diabetes distress among participants receiving digital health interventions compared with controls (MD = 0.34, 95% CI: −0.37 to 1.04; p = 0.35). Considerable heterogeneity was observed (I² = 98%). Subgroup analyses based on the Diabetes Distress Scale (DDS) and Problem Areas in Diabetes (PAID) scale also demonstrated non-significant effects. The certainty of evidence was rated as moderate. Funnel plot assessment and Egger’s regression test (p = 0.128) indicated no significant publication bias. Conclusion: Digital health interventions did not demonstrate a significant overall effect on diabetes distress among adults with T2DM. Although some individual studies reported beneficial outcomes, substantial heterogeneity limits definitive conclusions. Further high-quality, adequately powered RCTs are required to identify effective digital strategies for reducing diabetes-related distress.