Effect of social media–based diabetes self-management education and support on glycemic control in adults with type 2 diabetes: a systematic review and meta-analysis

Background Digital interventions are being used for diabetes self-management education and support (DSMES), but evidence of their effectiveness is limited. This review and meta-analysis examined the impact of social media-based DSMES on glycemic control in adults with type 2 diabetes (T2DM), and an exploratory post hoc analysis assessed the effect of intervention duration on outcomes. Methods A PRISMA 2020-compliant systematic review was conducted using PubMed, CINAHL, Web of Science, and PsycINFO, with 789 records screened and one additional record identified through a saved search (total of 790). Eligible studies were English-language articles published over a just-over-ten-year period. These studies focused on adults with T2DM, reported HbA1c outcomes, and utilized social media for DSMES interventions. Risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool for randomized controlled trials (RCTs). A random-effects meta-analysis estimated pooled mean differences (MD) in HbA1c percentage points, with subgroup analyses by intervention duration; heterogeneity was assessed using the I² statistic. Results This systematic review identified 13 studies, including 11 RCTs for the meta-analysis. The pooled analysis demonstrated a statistically significant overall effect favoring the intervention (MD = −0.44 HbA1c percentage points, 95% CI −0.87 to −0.00, p = 0.05). Substantial between-study heterogeneity was observed (I² = 91%), and the 95% prediction interval ranged from -2.08 to 1.20. Interventions of 3 months or less showed no significant effect (MD = -0.12, 95%CI -0.51 to 0.28, p = .56), whereas interventions longer than three months showed a large, statistically significant effect (MD = −1.02, 95% CI −1.75 to −0.29, p = 0.01). The test for between-subgroup differences was significant (Q = 4.56, df = 1, p = .03). Conclusion Social media-based DSMES interventions may be associated with improvements in glycemic outcomes in adults with T2DM. While interventions longer than three months showed greater pooled effects, interpret these post hoc results carefully because of significant heterogeneity (I² = 91%). This pooled estimate represents an average effect across heterogeneous interventions and populations and therefore should not be understood as a uniform effect of social media-based DSMES. Systematic review registration https://doi.org/10.17605/OSF.IO/BZR6P , OSF Registries BZR6P.