Digital education platforms for type 1 diabetes: a systematic literature review of clinical, behavioural and psychosocial outcomes

Background: Access to structured type 1 diabetes education is still limited globally, particularly in low- and middle-income countries (LMIC) [1]. Digital platforms offer scalable opportunities to support self-management; evidence is fragmented yet [2]. This review was conducted as part of the Educate4Diabetes PhD project, evaluating the HelloType1. HelloType1 is an online platform introduced by Action4Diabetes, a UK-registered charity, for delivering type 1 diabetes education in native languages across Southeast Asia (SEA).<br/><br/>Methods: A systematic review was conducted following PRISMA guidelines. The objective was to review and synthesise existing literature on the impact of digital education platforms in improving clinical, behavioural and psychosocial outcomes among individuals with type 1 diabetes, their caregivers and healthcare professionals in SEA. Five databases (MEDLINE, CINAHL, PsycINFO, Scopus and PubMed) and hand searches covering 2015 to 2025 were conducted. Data on key outcomes were extracted, and a narrative synthesis was undertaken to identify patterns across domains.<br/><br/>Results: Thirty-four studies were included covering programmes in North America, Europe, Asia and the Middle East. These include six RCTs, 10 Systematic Reviews and Meta Analysis, seven Feasibility or Observational Intervention Studies, six Cross-Sectional Studies and five Commentary Papers. Digital interventions showed modest but significant HbA1c reductions (0.3%–0.6%, p &lt; 0.05) and consistent behavioural gains in self-monitoring, insulin adjustment confidence and dietary and activity practices. Psychosocial outcomes were mixed, with reduced parental stress and improved self-efficacy but variable quality of life. Most interventions were feasible to implement and acceptable to users although sustained engagement and digital literacy remained challenges. Evidence on the impact of digital type 1 diabetes education programmes from SEA or LMIC was scarce.<br/><br/>Conclusion: Digital platforms modestly improve type 1 diabetes outcomes, though effectiveness depends on access and digital literacy. Most evidence originates from high-income countries, underscoring equity gaps. Findings inform the Educate4Diabetes study and HelloType1 adaptation, emphasising the need for inclusive, context-driven diabetes education research in LMIC settings.<br/><br/>References<br/><br/>[1] The Lancet Commission on diabetes: Using data to transform diabetes care and patient lives, Chan JCN et al., The Lancet, 2020.<br/><br/>[2] Comput Methods Programs Biomed: Digital interventions self-management education for type 1 and 2 diabetes: a systematic review and meta-analysis, Nkhoma DE et al., 2021.