Effects of Ecological Momentary Interventions on Glycated Hemoglobin, Body Mass Index, and Quality of Life in People with Type 2 Diabetes: A Review.

The global prevalence of type 2 diabetes mellitus (T2DM) continues to rise. Effective blood glucose and weight management are crucial for disease control and improving quality of life. Ecological momentary interventions (EMIs), which provide real-time personalized support based on ecological momentary assessments (EMAs) of relevant variables, offer a promising approach to promote adaptive self-management in daily life. We systematically searched five databases from inception to August 2025. Primary outcomes included glycated hemoglobin (HbA1c) and body mass index (BMI); secondary outcomes covered physical and mental health-related quality of life (HRQoL). Fourteen studies, including a total of 1,873 participants, were included. Compared to controls, EMIs significantly reduced HbA1c (MD = -0.71, 95% CI: -1.02 to -0.40, p < 0.001) and BMI (MD = -1.08, 95% CI: -1.90 to -0.26, p = 0.01), with substantial between-study heterogeneity (I2 = 84% and 92%, respectively). Subgroup analyses showed more consistent effects for multi-domain comprehensive EMIs, while the effects of single-domain EMIs varied depending on the intervention content. EMIs were also associated with modest improvements in physical (SMD = 0.37, 95% CI: 0.17 to 0.56, p < 0.001; I2 = 47%) and mental (SMD = 0.42, 95% CI: 0.15 to 0.68, p = 0.002; I2 = 0%) HRQoL. These findings suggest that EMIs, especially multi-domain comprehensive strategies, appear to be a promising intervention for T2DM management, yet the overall certainty of current evidence is limited by marked heterogeneity, restricted statistical power in subgroups, and some risk of bias, warranting cautious interpretation of the results. Future research should prioritize high-quality designs and comprehensive outcome assessments.