4 Apr, 13 | by Dr Dean Jenkins
A Cochrane systematic review of computer-based technology to support the self-management of people with Type 2 Diabetes has been published and it raises more questions than it answers. The authors concluded:
“Computer-based diabetes self-management interventions to manage type 2 diabetes appear to have a small beneficial effect on blood glucose control and the effect was larger in the mobile phone subgroup. There is no evidence to show benefits in other biological outcomes or any cognitive, behavioural or emotional outcomes.” 
Whilst there is a great potential for computer-based technologies to support people with diabetes – especially, perhaps, where there is connectivity through wireless internet connections – the authors point out that there remains uncertainty about which active components of these types of interventions actually work.
These computer-based interventions are complex and despite the enthusiasm of a number of mHealth, telemedicine, and telehealth supporters it is clear that technology in itself is not necessarily an effective tool. Aspects of the design around the use of theoretical models of behaviour change need to be explored.
I don’t see this review as negative as the summary reads. A small (albeit expensive) effect on blood glucose is to be welcomed. This is review that points out that the initial enthusiasm for mobile technologies show some promise but more rigorous research needs to be undertaken to see which aspects work. Designers of computer-based applications to support people with diabetes should work more closely across disciplines including human-computer-interface design and theoretical models of behaviour change.
1. Pal K, Eastwood SV, Michie S, Farmer AJ, Barnard ML, Peacock R, Wood B, Inniss JD, Murray E. Computer-based diabetes self-management interventions for adults with type 2 diabetes mellitus. In: Cochrane Database of Systematic Reviews. John Wiley & Sons, Ltd; 1996 Available from: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008776.pub2/abstract