Effectiveness of digital and telemedicine interventions for gestational diabetes mellitus: An umbrella review of systematic reviews and meta-analyses.
Simin Zhuang, Mengting Yu, Hoi Lam Ip et al.
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In 30 seconds
This umbrella review synthesized 24 systematic reviews covering 144 primary studies and 41,384 participants to assess digital and telemedicine interventions for gestational diabetes mellitus. Random-effects meta-analyses found lower glucose measures with these interventions: 2-hour postprandial glucose decreased by 1.19 mmol/L (95% CI - 1.52 to - 0.85), graded as strong positive evidence. HbA1c and fasting glucose also improved, with weak positive evidence. Reviews additionally reported benefits for several maternal, delivery, and neonatal outcomes, but evidence for long-term outcomes was limited.
Key findings
- 2-hour postprandial glucose was lower by 1.19 mmol/L (95% CI - 1.52 to - 0.85), with strong positive evidence.
- HbA1c decreased by 0.72% (95% CI: - 0.93 to - 0.51), graded as weak positive evidence.
- Fasting blood glucose decreased by 0.70 mmol/L (95% CI - 0.89 to - 0.50), graded as weak positive evidence.
- Weak positive evidence indicated benefits for selected maternal, delivery, neonatal macrosomia, and gestational weight-gain outcomes.
Why it matters
The review brings together a large body of evidence suggesting that digital and telemedicine approaches may support glycaemic management in gestational diabetes and may also affect pregnancy outcomes. The strongest evidence concerned postprandial glucose, while evidence for other outcomes was weaker. The findings help clarify where benefits appear most consistent and highlight the need to assess longer-term maternal and offspring outcomes.
What to keep in mind
The underlying reviews were methodologically heterogeneous, and evidence for long-term maternal and offspring outcomes was limited. The authors call for high-quality trials with extended follow-up.