Abstract

Background: Type 2 Diabetes Mellitus (T2DM) remains a major global public health costing millions of lives and leading to huge burden of comorbidities and straining health institutions. Mobile apps and other Digital Health Interventions (DHIs) aimed at facilitating lifestyle changes to prevent diabetes are the recent innovative approaches to prevent diabetes and promote risk reduction. This umbrella review aims to synthesize current evidence from existing systematic reviews on the effectiveness of DHIs in preventing T2DM with a focus on their role in promoting lifestyle modifications and reducing diabetes risk.

Methods: This is an umbrella review of previous systematic reviews and meta-analyses published between 2015 and 2025. The literature search involves databases, such as PubMed, Cochrane Library, Scopus, MEDLINE, and CINAHL. Eligible articles are those that focused on diabetes prevention and investigated diabetes education and lifestyle interventions for participants with prediabetes, overweight, obesity, and metabolic syndrome and examined the outcomes of lifestyle changes, diabetes, glycemic control, and diabetes incidence. Intervention data were categorized by type of intervention, duration, and primary outcomes, and effect size.

Results: This umbrella review included 13 eligible systematic reviews and meta-analyses, containing different primary studies. The findings indicate that DHIs result in weight loss (average of 2.5-4.8 kg or -3.98%) while also decreasing HbA1c levels (0.3% to 0.5%). The most effective interventions were those that incorporated interactive features, including behavior change techniques, such as self-monitoring, goal setting, and goal attainment real-time feedback. Most reviews demonstrate that while fully automated DHIs are effective, interventions that integrate digital technology and human interaction (e.g., remote coaching) achieve better results, especially in terms of long-term sustainability, adherence and effectiveness. Success was commonly attributed to user engagement, content personalization, and optimal platform usability. The reviews and meta-analyses identified predominantly included studies conducted in Europe and United States of America, with the least studies from Asia while none was conducted in the Middle-East or Saudi Arabia. The methodological quality of the synthesis was low, underscoring the need for further primary and secondary research.  

Conclusion: Digital Health Interventions are an effective and practical method for the prevention of T2D. They bring about necessary lifestyle changes and improve significant metabolic parameters in populations that are most at risk. Their ease of implementation and wide availability makes them an important part of contemporary public health strategy. Subsequent use of these interventions should focus on evidence-based behavior change techniques and the most effective combinations of digital health technology and human interaction for sustained long-term adherence and effectiveness. Remaining gaps include long term equity of access, especially in low-resource settings and among people with low digital literacy. Moreover, the findings underscore the pressing needs of extensive research exploring DHIs in T2DM prevention in Arab countries, especially Saudi Arabia, which is one of the countries with the highest burden of diabetes.