{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T06:09:05Z","timestamp":1789193345519,"version":"build-2803163510"},"reference-count":41,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"unspecified","delay-in-days":10,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Shenzhen Key Medical Discipline Construction Fund","award":["No.SZXK062"],"award-info":[{"award-number":["No.SZXK062"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,8,8]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Type 2 diabetes mellitus (T2DM) affects hundreds of millions of people worldwide. Self-management education is a cornerstone of diabetes care. Digital technology-based interventions have demonstrated short-term benefits; however, their medium-term to long-term effects remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analyses<\/jats:title>\n                    <jats:p>We will systematically search seven databases (PubMed, Embase, the Cochrane Library, the China National Knowledge Infrastructure [CNKI], the China Biomedical Literature Database [CBM], Wanfang and the China Science Journal Database [VIP]) and three clinical trial registries (ClinicalTrials.gov, Chinese Clinical Trial Registry [ChiCTR] and WHO International Clinical Trials Registry Platform [ICTRP]) from inception to March 2026. We will include randomised controlled trials that provide diabetes self-management education via digital technologies, such as mobile applications, websites, text messaging, remote monitoring or computer programmes. Interventions may be fully digital or hybrid, provided that digital technology is the core delivery method. Eligible studies will involve adults with T2DM or studies in which at least 80% of the participants have T2DM, with a minimum follow-up of 12 months. Primary outcomes will be mortality, diabetes-related complications, hospitalisations, severe hypoglycaemia, quality of life and glycated haemoglobin. Secondary outcomes include fasting plasma glucose, lipids, blood pressure, anthropometric measures and patient-reported outcomes such as self-management behaviours and diabetes distress. Two reviewers will independently screen studies, extract data and assess the risk of bias using the Cochrane Risk of Bias 2 (RoB 2) tool. Where data are sufficient and studies are adequately comparable in terms of participants, interventions, comparators, outcomes and study design, we will perform meta-analyses using Cochrane Review Manager (RevMan) V.5.3 and Stata V.19.0. Heterogeneity will be explored through subgroup analyses and meta-regression. The certainty of evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>As this study will synthesise the published data, ethical approval is not required.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration number<\/jats:title>\n                    <jats:p>CRD420251135023.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-119389","type":"journal-article","created":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T05:15:45Z","timestamp":1789190145000},"page":"e119389","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Medium-term to long-term effect of digital self-management interventions for type 2 diabetes mellitus: protocol of a systematic review"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-6120-5786","authenticated-orcid":false,"given":"Danping","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Nursing, Shantou University Medical College, Shantou, GuangDong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Shenzhen University \/ Shenzhen Luohu People's Hospital, Shenzhen, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanhang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Shantou University Medical College, Shantou, GuangDong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingxin","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Shantou University Medical College, Shantou, GuangDong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"key":"2026091122152471000_16.9.e119389.1","unstructured":"Federation ID . IDF. 2025. 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The economic impact of mobile health interventions on medical expenditure of diabetic patients","volume":"33","author":"Liu","year":"2026","journal-title":"J Am Med Inform Assoc"},{"key":"2026091122152471000_16.9.e119389.12","doi-asserted-by":"crossref","DOI":"10.1186\/s40842-024-00201-9","article-title":"Online diabetes self-management education application for reducing glycated hemoglobin level among patients with type 1 diabetes mellitus: a systematic review and meta-analysis","volume":"10","author":"Usefi","year":"2024","journal-title":"Clin Diabetes Endocrinol"},{"key":"2026091122152471000_16.9.e119389.13","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1177\/26350106241285827","article-title":"Utilization of Diabetes Self-Management Education and Support Among Medicare Beneficiaries Newly Diagnosed With Diabetes in Arkansas, 12 Months Postdiagnosis (2015-2018)","volume":"50","author":"Rezaeiahari","year":"2024","journal-title":"Sci Diabetes Self Manag Care"},{"key":"2026091122152471000_16.9.e119389.14","doi-asserted-by":"crossref","DOI":"10.2196\/25295","article-title":"Early Insights From a Digitally Enhanced Diabetes Self-Management Education and Support Program: Single-Arm Nonrandomized Trial","volume":"6","author":"Wilson-Anumudu","year":"2021","journal-title":"JMIR Diabetes"},{"key":"2026091122152471000_16.9.e119389.15","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1177\/26350106241285829","article-title":"Digital Health Tools and Behavioral Strategies to Increase Engagement With Diabetes Self-Management Education and Support: Design and Feasibility of DM-BOOST","volume":"50","author":"Amante","year":"2024","journal-title":"Sci Diabetes Self Manag Care"},{"key":"2026091122152471000_16.9.e119389.16","doi-asserted-by":"crossref","first-page":"1206","DOI":"10.1177\/19322968231174037","article-title":"Mobile Applications to Support Diabetes Self-Management Education: Patient Experiences and Provider Perspectives","volume":"17","author":"Krall","year":"2023","journal-title":"J Diabetes Sci Technol"},{"key":"2026091122152471000_16.9.e119389.17","doi-asserted-by":"crossref","DOI":"10.2196\/jmir.8439","article-title":"Digital Health Interventions for Adults With Type 2 Diabetes: Qualitative Study of Patient Perspectives on Diabetes Self-Management Education and Support","volume":"20","author":"Pal","year":"2018","journal-title":"J Med Internet Res"},{"key":"2026091122152471000_16.9.e119389.18","doi-asserted-by":"crossref","DOI":"10.2196\/55757","article-title":"Digital Interventions for Self-Management of Type 2 Diabetes Mellitus: Systematic Literature Review and Meta-Analysis","volume":"26","author":"Kerr","year":"2024","journal-title":"J Med Internet Res"},{"key":"2026091122152471000_16.9.e119389.19","first-page":"1399","article-title":"Research progress in the application of digital therapeutics in diabetic foot patients","volume":"60","author":"Zhang","year":"2025","journal-title":"Chinese Journal of Nursing"},{"key":"2026091122152471000_16.9.e119389.20","article-title":"Digital Diabetes Management Technologies for Type 2 Diabetes: A Systematic Review of Home-Based Care Interventions","volume":"17","author":"Abdul Latif El Ejel","year":"2025","journal-title":"Cureus"},{"key":"2026091122152471000_16.9.e119389.21","doi-asserted-by":"crossref","DOI":"10.2196\/60380","article-title":"Application of Chatbots to Help Patients Self-Manage Diabetes: Systematic Review and Meta-Analysis","volume":"26","author":"Wu","year":"2024","journal-title":"J Med Internet Res"},{"key":"2026091122152471000_16.9.e119389.22","doi-asserted-by":"crossref","first-page":"976","DOI":"10.1177\/1932296821997178","article-title":"Follow-Up of a Massive Open Online Course in Type 2 Diabetes Self-Management Education","volume":"15","author":"Mackenzie","year":"2021","journal-title":"J Diabetes Sci Technol"},{"key":"2026091122152471000_16.9.e119389.23","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1016\/j.pcd.2025.08.010","article-title":"The effect of online health management on type 2 diabetes mellitus: A systematic review and meta-analysis","volume":"19","author":"Qiu","year":"2025","journal-title":"Prim Care Diabetes"},{"key":"2026091122152471000_16.9.e119389.24","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1111\/dme.14256","article-title":"Trends in diabetes self-management education: where are we coming from and where are we going? 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Chapter 3: defining the criteria for including studies and how they will be grouped for the synthesis. In: Higgins JPT , Thomas J , Chandler J , et al ., eds. Cochrane Handbook for Systematic Reviews of Interventions version 6.5. Cochrane, 2024. 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Chapter 10: analysing data and undertaking meta-analyses [last updated november 2024]. In: Higgins JPT , Thomas J , Chandler J , et al ., eds. Cochrane Handbook for Systematic Reviews of Interventions version 6.5. Available from. Cochrane, 2024. 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