title: The Effect of Technology-Mediated Diabetes Prevention Interventions on Weight: A Meta-Analysis.
abstract: Lifestyle interventions targeting weight loss, such as those delivered through the Diabetes Prevention Program, reduce the risk of developing type 2 diabetes. Technology-mediated interventions may be an option to help overcome barriers to program delivery, and to disseminate diabetes prevention programs on a larger scale.
  
  
  
  We conducted a meta-analysis to evaluate the effect of such technology-mediated interventions on weight loss.
  
  
  
  In this meta-analysis, six databases were searched to identify studies reporting weight change that used technology to mediate diet and exercise interventions, and targeted individuals at high risk for developing type 2 diabetes. Studies published between January 1, 2002 and August 4, 2016 were included.
  
  
  
  The search identified 1196 citations. Of those, 15 studies met the inclusion criteria and evaluated 18 technology-mediated intervention arms delivered to a total of 2774 participants. Study duration ranged from 12 weeks to 2 years. A random-effects meta-analysis showed a pooled weight loss effect of 3.76 kilograms (95% CI 2.8-4.7; P<.001) for the interventions. Several studies also reported improved glycemic control following the intervention. The small sample sizes and heterogeneity of the trials precluded an evaluation of which technology-mediated intervention method was most efficacious.
  
  
  
  Technology-mediated diabetes prevention programs can result in clinically significant amounts of weight loss, as well as improvements in glycaemia in patients with prediabetes. Due to their potential for large-scale implementation, these interventions will play an important role in the dissemination of diabetes prevention programs.
authors.affiliation: University of Michigan Medical School, Ann Arbor, MI, United States.
authors.forename: Rachel R
authors.identifier: 0000-0002-4809-489X
authors.initials: RR
authors.lastname: Bian
authors.affiliation: Department of Learning Health Sciences, University of Michigan, Ann Arbor, MI, United States.
authors.forename: Gretchen A
authors.identifier: 0000-0001-6641-6330
authors.initials: GA
authors.lastname: Piatt
authors.affiliation: University of Michigan, Department of Family Medicine, Ann Arbor, MI, United States.|University of Michigan, Department of Biostatistics, School of Public Health, Ann Arbor, MI, United States.
authors.forename: Ananda
authors.identifier: 0000-0002-9632-6704
authors.initials: A
authors.lastname: Sen
authors.affiliation: University of Michigan, Department of Family Medicine, Ann Arbor, MI, United States.
authors.forename: Melissa A
authors.identifier: 0000-0001-6032-534X
authors.initials: MA
authors.lastname: Plegue
authors.affiliation: University of Michigan, Department of Internal Medicine, Ann Arbor, MI, United States.
authors.forename: Mariana L
authors.identifier: 0000-0002-3891-4436
authors.initials: ML
authors.lastname: De Michele
authors.affiliation: University of Michigan, Department of Internal Medicine, Ann Arbor, MI, United States.
authors.forename: Dina
authors.identifier: 0000-0002-2260-0299
authors.initials: D
authors.lastname: Hafez
authors.affiliation: University of Michigan, Department of Family Medicine, Ann Arbor, MI, United States.
authors.forename: Christina M
authors.identifier: 0000-0002-3033-9641
authors.initials: CM
authors.lastname: Czuhajewski
authors.affiliation: University of Michigan, Department of Family Medicine, Ann Arbor, MI, United States.|University of Michigan, School of Information, Ann Arbor, MI, United States.
authors.forename: Lorraine R
authors.identifier: 0000-0001-5855-9972
authors.initials: LR
authors.lastname: Buis
authors.affiliation: Geffen School of Medicine and Fielding School of Public Health, Departments of Pediatrics and Public Health, University of California, Los Angeles, CA, United States.
authors.forename: Neal
authors.identifier: 0000-0002-2202-9547
authors.initials: N
authors.lastname: Kaufman
authors.affiliation: University of Michigan, Department of Family Medicine, Ann Arbor, MI, United States.
authors.forename: Caroline R
authors.identifier: 0000-0002-1945-6046
authors.initials: CR
authors.lastname: Richardson
mesh_terms: D020811:Biomedical Technology; D001835:Body Weight; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control*; D006801:Humans; D015431:Weight Loss / Q000502:physiology*
keywords: diabetes mellitus, type 2; meta-analysis; prediabetic state; technology; weight reduction programs