Understanding Artificial Pancreas Systems: Results from a 24-Month Trial

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Effectiveness is rated as mixed because results varied widely across studies. Overall, HbA1c dropped by about 1%, which is meaningful for reducing diabetes complications. However, results ranged from small improvements to large benefits. Three studies showed clear benefits while three others showed less certain results. The wide variation appears related to differences in study size, length, and which tools were used. While the overall effect shows benefit, the inconsistency means results may not be the same in all settings.

SMS text messaging behavioral intervention for health promotion

Global studies of mobile health tools show similar results. A 2011 review found text-based tools reduced HbA1c by about 0.5%. A 2017 review found a 0.4% reduction. Both are comparable to the 1% reduction found in this African review, though African results varied more widely.

This African review differs from global research in important ways. Far fewer studies exist in Africa compared to other regions. Most African studies used older technology like text messages rather than modern smartphone apps. Results varied more between African studies than is typical in global reviews, possibly reflecting differences in healthcare systems and mobile technology access across the continent.

Confidence is moderate because the review used strong methods and found a meaningful drop in HbA1c. However, only six studies exist from five countries. Results varied widely between studies, which limits how confident we can be that the benefits will be the same everywhere. Most studies were well-designed, though one had quality concerns.

Mobile health tools like texts and phone apps may help reduce HbA1c by about 1% in adults with type 2 diabetes in Africa

Benefits vary considerably—some people may see larger improvements while others see smaller changes

Evidence comes from only five African countries and focuses on short-term blood sugar control, not long-term complications

The results suggest mobile health tools may help improve blood sugar control in African settings, with benefits similar to what's been seen globally

Evidence is clearest that these tools are acceptable and feasible to use—nearly all participants found them helpful

It's less clear which specific type of tool works best or how long the benefits last

Most studies used basic technology like text messages, so modern smartphone apps might work differently but need more research in African settings

The studies tested different mobile health tools for diabetes management. Four studies used text messages to send education, reminders, and encouragement. One study used phone calls from nurses providing counseling and support. One study tested a mobile app that tracked blood sugar and gave feedback to both patients and their care teams.

All tools aimed to help people better manage their diabetes between doctor visits. The intensity varied—some sent daily messages, others weekly. Study lengths ranged from 2 months to 12 months. All participants continued their regular diabetes care and medications while using the mobile tools.

Mobile health intervention, SMS text messaging for health behavior change, telemedicine monitoring for diabetes, mobile application for chronic disease management, nurse-led telephone counseling, diabetes self-management education via mobile technology

Dike FO, Mutabazi JC, Musa E, Ubani BC, Isa AS, Ezeude CM, Iheonye H, Ainavi II. Implementation and impact of mhealth in the management of diabetes mellitus in Africa: A systematic review and meta-analysis. PLOS Digit Health. 2025;4(4):e0000776. doi:10.1371/journal.pdig.0000776

People using mobile health tools saw their HbA1c drop by about 1% on average, which is a meaningful improvement for reducing diabetes complications. Results ranged widely across studies—some showed small improvements while others showed larger benefits. Three of the six studies showed clear benefits on their own, while three others had less certain results.

Results varied considerably between studies, likely due to differences in how long they lasted, how many people participated, and which tools they used. All participants found the mobile tools acceptable and easy to use. None of the studies looked at whether the tools help prevent diabetes complications like kidney or eye problems.

Most used older technology like text messages

No data on preventing complications long-term

Mobile health tools may improve blood sugar control in African diabetes patients, but benefits vary.

Only six studies from five African countries means these findings may not apply everywhere across the continent. Results varied a lot between studies, so the benefits may not be consistent. All studies focused on type 2 diabetes only—no research exists yet on type 1 diabetes or gestational diabetes in African settings.

Most tools used older technology like text messages and phone calls rather than modern smartphone apps. Study lengths varied from 2 months to 12 months, making it hard to compare results or know if the benefits last long-term. None of the studies looked at whether mobile tools help prevent diabetes complications like kidney disease or vision loss, which are major health concerns.

User acceptance → ↑ (strong acceptance)

Effect of mobile phone intervention for diabetes on glycaemic control: A meta-analysis

Bonoto BC et al., JMIR mHealth and uHealth 2017

Efficacy of Mobile Apps to Support the Care of Patients With Diabetes Mellitus: A Systematic Review and Meta-Analysis

Eberle C et al., JMIR mHealth and uHealth 2021

Effectiveness of Disease-Specific mHealth Apps in Patients With Diabetes Mellitus: Scoping Review

Mao Y et al., BMJ Open Diabetes Research & Care 2020

Impact and efficacy of mobile health intervention in the management of diabetes and hypertension: A systematic review and meta-analysis

mHealth: New horizons for health through mobile technologies

Researchers searched multiple databases for studies conducted in Africa between 2010 and 2020. They looked for trials testing mobile health tools for diabetes management. Two reviewers independently screened studies and assessed quality. They included randomized controlled trials and similar study designs that measured blood sugar control.

The review combined results from five studies measuring HbA1c levels. The team assessed study quality using standard tools and looked for differences in how well the interventions worked across different settings. They followed established review guidelines and registered the review in advance.

Mobile health tools may improve blood sugar control in African diabetes patients

This review looked at whether mobile health tools like text messages and phone apps help people with type 2 diabetes in Africa manage their condition. Researchers found six studies from five African countries involving over 3,000 adults. The tools included text message reminders, phone calls from nurses, and diabetes management apps.

Overall, people using mobile health tools saw their HbA1c levels drop by about 1%, which is a meaningful improvement. However, results varied widely between studies. All participants found the mobile tools easy to use and helpful. The evidence is moderate because only six small studies exist, and they used different approaches in different settings.

Only six studies from five countries means these findings may not represent all African healthcare settings

Wide variation in results means benefits may not be predictable when starting new programs without local adaptation

No information exists yet on long-term benefits, cost-effectiveness, or impact on serious complications

Review of 6 studies with 3,112 adults with type 2 diabetes in Africa over 2-12 months

Adults with type 2 diabetes who have access to a basic mobile phone, especially in areas where regular clinic visits are difficult. May be most useful in healthcare systems with limited staff or resources where mobile tools can provide support between appointments.

Adults with type 2 diabetes living in Africa or other resource-limited settings with access to mobile phones. Particularly relevant for patients in healthcare systems with limited in-person diabetes care capacity, where mobile technology can extend reach of diabetes education and self-management support. May apply to other low- and middle-income countries facing similar healthcare delivery challenges.

This review looked at whether mobile health tools like text messages and phone apps help people with type 2 diabetes in Africa manage their condition. Researchers found six studies from five African countries involving over 3,000 adults. The tools included text message reminders, phone calls from nurses, and diabetes management apps.
Overall, people using mobile health tools saw their HbA1c levels drop by about 1%, which is a meaningful improvement. However, results varied widely between studies. All participants found the mobile tools easy to use and helpful. The evidence is moderate because only six small studies exist, and they used different approaches in different settings.

Mobile health tools may improve blood sugar control in African diabetes patients

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