Smart Tools for Early Glycemic Control: A Systematic Review of Tech-Enabled Prediabetes Interventions

Abstract

Background: Prediabetes is a universal health problem that affects more than 480 million persons worldwide and is a major contributor in advancing to type 2 diabetes mellitus (T2DM). However, traditional systems have shortcomings in scalability, personalization, and accessibility, and early intervention is vital. Mobile applications, wearables, AI platforms, SMS/chatbots, and other digital health technologies may serve as a strong substitute for glycemic management and health-related behavioral interventions.

 Objective: To systematically assess the functionality, usability and sociodemographic coverage of smart tools for prediabetes management.

 Methods: A wide-ranging search was performed in eight databases for the studies published from 2010 to 2025. The eligible studies comprised of randomized controlled trials, cohort studies, and cross-sectional analyses aimed at adults with prediabetes. Interventions were divided into four modalities. Outcomes were glycemic control (HbA1c, fasting glucose), user engagement, cost-effectiveness, and usability (e.g. PUEQ scores). RoB 2 and ROBINS-I tools were used to assess risk of bias.

 Results: Fifty-four studies achieved eligibility criteria. Mobile apps and AI platforms exert the biggest impact on glycemic outcomes, with HbA1c reductions anywhere from −0.3% to −0.6%. The wearables improved the physical activity and fasting glucose. In low-resource environments, SMS/chatbot systems showed robust levels of engagement. Usability scores were highest with bilingual, personalized tools. Sociodemographic profile revealed uneven access and digital literacy.

Conclusion: Smart tools are robust and scalable for the management of prediabetes, but ethical design, outcomes for long-term follow-up, and equity for all are all areas in need of focus. Culturally-adapted, universal technologies can improve prevention and decrease the worldwide burden of T2DM.