Effectiveness of mHealth interventions on glycemic outcomes in adults with type 2 diabetes in Gulf countries: a systematic review and meta-analysis

Type 2 diabetes mellitus (T2DM) poses a major public health challenge in Gulf countries and has among the highest global prevalence; although mobile health (mHealth) interventions have demonstrated global benefits for diabetes self-management, region-specific evidence remains limited. To assess the effectiveness of mHealth interventions compared with usual care for glycemic control among adults with T2DM in Gulf countries. A systematic review and meta-analysis were conducted following PRISMA guidelines. PubMed, Scopus, Web of Science, and Cochrane CENTRAL were searched from inception to May 15, 2025. Randomized controlled trials (RCTs) and analytical observational studies comparing mHealth interventions with usual care in adults with T2DM in Gulf countries were included. The risk of bias was assessed using the Cochrane RoB 2 tool and the Newcastle–Ottawa Scale. A random-effects meta-analysis estimated pooled mean differences in HbA1c. The search yielded 516 records, of which three studies involving 371 participants (mHealth n = 216; usual care n = 155) met the inclusion criteria. Two studies were conducted in Saudi Arabia, and one was conducted in the United Arab Emirates. Interventions included WhatsApp-based diabetes self-management education, mHealth-enabled health coaching, and hybrid care models with remote monitoring. The primary meta-analysis revealed a statistically significant reduction in HbA1c, favoring mHealth interventions compared with usual care (pooled mean difference − 0.86%; 95% CI: −1.48 to − 0.24; I² = 0%). However, sensitivity analysis including only RCTs yielded an inconclusive estimate, with a pooled mean difference of − 1.02% (95% CI: −6.34 to 4.29; I² = 49%). Limited evidence suggests that mHealth interventions may improve glycemic control among adults with type 2 diabetes in Gulf countries. However, the evidence should be interpreted cautiously given the small number of studies and the inconclusive findings of the sensitivity analysis. Larger, high quality RCTs with longer follow-up periods are needed to confirm their effectiveness and inform policy.