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

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Non-randomized (moderate): Randomization not used or not reported

No control group (high): Single-arm or uncontrolled design

Open-label or unblinded (moderate): No blinding reported

High risk of bias (high): Overall bias rated high

{"intervention_arm_id":"arm_1","reference_arm_ids":[],"comparison_type":"pre_post"}

HbA1c 8.61±1.70 to 7.92±1.60; t=5.107; p<0.001

Mean HbA1c decreased from 8.61% to 7.92% after 3 months (absolute change −0.69; paired t=5.107, p<0.001).

Total self-care score 96.35±21.39 to 132.10±22.49; t=12.359; p<0.001

Total self-care score increased from 96.35 to 132.10 with improvement across all reported self-care domains over 3 months.

A structured, moderated WhatsApp group intervention delivering diabetes self-care education and follow-up support over three months.

Positive: 2; Negative: 0; No effect: 0; Mixed: 0

Extracted 2 outcome signals across the study

Both extracted outcomes moved in a favorable direction, but certainty is reduced by non-randomized single-arm design.

↓ HbA1c changed from 8.61% to 7.92% over 3 months

↑ Total diabetes self-care score improved from 96.35 to 132.10

Mostly intermediate or surrogate outcomes

A structured WhatsApp education workflow was linked with improved self-care scores in this cohort

HbA1c showed moderate improvement over the intervention period

Without a control group, causal certainty remains limited

Alhazmy RS, Khalil AH, Almutary H. Effects of an instructional WhatsApp group on self-care and HbA1c among female patients with type 2 diabetes mellitus. PLoS One. 2024;19(9):e0305845. doi:10.1371/journal.pone.0305845

Short follow-up and no long-term durability data

In this 3-month pre-post study, a nurse-led instructional WhatsApp group was linked with better diabetes self-care scores and a moderate drop in HbA1c among women with type 2 diabetes.

↑ Self-care domains improved across diet, exercise, monitoring, adherence, follow-up, and foot care

Instructions were shared daily as pictures, videos, and messages; discussion hours were 6:00-8:00 p.m.

Instructional WhatsApp group

No control group (high): No parallel control group reported

Includes self-reported outcomes (moderate): Self-reported outcomes used

Limited population scope (moderate): Narrow population scope

WhatsApp self-care education may improve HbA1c and daily self-care in women with type 2 diabetes

This study followed 62 women with type 2 diabetes in Saudi Arabia during a 3-month WhatsApp education program. Self-care scores improved across all measured areas, and average HbA1c fell from 8.61% to 7.92%. Because there was no separate control group, the size of the true intervention effect remains uncertain.

Findings come from a pre-post design, not a randomized trial

Participants may improve partly because they were being monitored

Results may not generalize to men or other healthcare settings

Long-term maintenance beyond 3 months was not evaluated

A 3-month instructional WhatsApp group for diabetes self-care and HbA1c outcomes.

Patients able to read Arabic and use WhatsApp

Intervention	Outcome	Measured Change	Study Effect
WhatsApp-based diabetes self-care education program (Behavioral & Lifestyle)	HbA1c (Glycemic Control)	Decrease	Limited
WhatsApp-based diabetes self-care education program (Behavioral & Lifestyle)	Self-management behaviors (Adherence & Engagement)	Increase	Mixed

WhatsApp self-care education may improve HbA1c and daily self-care in women with type 2 diabetes

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