Impact of technology use in type 2 diabetes distress: A systematic review

Table 1 Data extracted

Ref.	Sample	SSC	Age average	Gender	Duration	IEWT	CGITE	DDS version used and data results	Statistical significance between groups
Fisher et al[15], 2014	392	No	56	53.8% Female, 46.2% Male	48 wk	My path to a healthy life computer-assisted self-management plus problem-solving therapyTechnology: Phone calls and web-based diabetes self-management and diabetes distress change program	Leap ahead program delivers diabetes information only, and participants were not directed to use the information to engage in a specific or structured program of self-management or diabetes distress change	DDS (5- item Regimen Distress Subscale and 5-item Emotional Burden Subscale from DDS)	P = 0.50, No significant
Nobis et al[16], 2015	260	Yes	51	63% Female, 37% Male	8 wk	GET.ON Mood Enhancer personalized, guided, Internet-based diabetes self-help intervention with personalized feedback from psychologist	Control Group: Unguided psychoeducation program	DDS (PAID-5)	P < 0.001, Significant
Bajaj et al[17], 2016	139	Yes	56.4	NR	12 wk	Long-acting insulin glargine Titration Web Tool (LTHome), instructions on insulin administration and dosing, as well as the use of the web-based LTHome tool (containing a rules engine-based algorithm for titration), provided by a delegated nonhealthcare professional Technology: Web-based insulin titration algorithm embedded in a range of platforms, including glucometer, personal computer and mobile phones	EUT of Glargine Titration: Insulin dosing and titration instructions were provided by CDEs according to a standard protocol	17-item DDS	P = 0.04; Significant
Rondags et al[18], 2016	137	Yes	52	46% Female, 54% Male	24 wk	HypoAware consists of three group sessions and is combined with two online modules. Group sessions are highly interactive and aimed at patient empowerment to improve symptom recognition, risk awareness, preventive and problem-solving strategies and coping with (the risk of) hypoglycemia Technology: two online modules	Care as usual had access to comprehensive diabetes care as normally provided by their diabetes team	DDS (PAID-5)	P = 0.365, No significant
Holland-Carter et al[19], 2017	563	Yes	55.1	71% Female, 29% Male	48 wk	WW approach, supplemented with phone and email counseling with a CDE Technology: WW online tools, unlimited phone calls and email diabetes educator consultation	SC, one session of face-to-face T2DM nutritional counseling by a registered dietitian as well as follow-up written information	17-item DDS	P < 0.001, Significant
Newby et al[20], 2017	106	Yes	47	71% Female, 29% Male	10 wk	ICBT not tailored to diabetes	TAU control group	DDS (PAID 20 items)	P < 0.001, Significant
Ebert et al[21], 2017	260	Yes	50.8	43.8% Female, 56.2% Male	24 wk	GET.ON Mood Enhancer personalized, guided, Internet-based diabetes self-help intervention with personalized feedback from psychologist Technology: active online training on diabetes and depression, personalized approach	Control: Usual treatment	DDS (PAID-5)	P < 0.001, Significant
Schlicker et al[22], 2019	253	No	50.7	62.8% Female, 37.2% Male	24 wk	GET.ON Mood Enhancer personalized, guided, Internet-based diabetes self-help intervention with personalized feedback from psychologist	Placebo online, online psychoeducation control condition	DDS (PAID-5)	P = 0.75, No significant
Clarke et al[23], 2019	780	Yes	58	68.8% Female, 31.2% Male	12 wk	My compass program is a fully automated, web- based cognitive behavioral, self-guided public health treatment program for common mental health problems with a personalized treatment plan based on an assessment of user symptoms. Technology: Web-based, fully automated program with self-guided cognitive behavioral treatment through personal computer or mobile phone	Healthy lifestyles: Placebo without therapeutic, only informative, no feedback content	17-item DDS	P = 0.36, No significant

P values < 0.05 were considered statistically significant. SSC: Sample size calculation; IEWT: Intervention elaborated with technology; CGITE: Control group with no intervention technology elaborated; DDS: Diabetes distress scale; EUT: Enhanced usual therapy; CDE: Certified diabetes educator; WW: Weight watchers; SC: Standard care; T2D: Type 2 diabetes; ICBT: Internet cognitive behavioral therapy; TAU: Treatment as usual; NR: Not related.