Abstract
Introduction: Type 2 Diabetes Mellitus (T2DM) affects approximately 537 million adults worldwide, with optimal glycemic control achieved by fewer than 20% of patients globally. While mobile health (mHealth) interventions and family support have individually demonstrated effectiveness in diabetes management, the impact of integrating family involvement with mHealth technologies remains understudied. This systematic review aimed to evaluate the effectiveness of mHealth interventions that incorporate family members as active support partners in improving diabetes self-management and glycemic control among patients with type 2 diabetes mellitus.Methods: A systematic literature search was conducted across four electronic databases (MEDLINE, CINAHL, CENTRAL, and Web of Science) for studies published from 2007 onwards. The review followed PRISMA guidelines and JBI methodology. Studies examining mHealth diabetes interventions that actively involved family members, caregivers, or support persons were included. Two reviewers independently screened studies and assessed methodological quality using the Mixed Methods Appraisal Tool (MMAT). Data were extracted systematically and synthesized using narrative synthesis due to study heterogeneity.Results: Ten studies met inclusion criteria, comprising four randomized controlled trials, two mixed-methods studies, two feasibility studies, one mixed-methods evaluation, and one action research pilot study. Studies included 7 to 512 participants, with intervention durations ranging from 2 weeks to 15 months. All studies demonstrated improvements in glycemic control, with HbA1c reductions ranging from 0.97% to 1.4% in intervention groups. Text messaging-based interventions emerged as the most effective platform, with 48% of participants actively engaging family support. Family involvement was associated with enhanced diabetes self-efficacy, improved dietary behaviors, and increased treatment adherence. Cultural adaptation and autonomy-supportive family behaviors were identified as critical success factors. MMAT scores ranged from 60% to 100%, indicating generally robust methodological quality.Conclusion: Mobile health interventions incorporating family support demonstrate consistent effectiveness in improving glycemic control and diabetes self-management behaviors among adults with T2DM. Text messaging platforms showed particular promise for family engagement, though intervention success depends on culturally appropriate design and autonomy-supportive family involvement. These findings support integrating family-supported digital health interventions into routine diabetes care, with attention to cultural adaptation and family dynamics optimization.