Effectiveness of digital and telemedicine interventions for gestational diabetes mellitus: An umbrella review of systematic reviews and meta-analyses.

BACKGROUND: Digital and telemedicine interventions show promise for managing gestational diabetes mellitus, but existing meta-analytic research is methodologically heterogeneous, with studies varying in intervention components, delivery platforms, and outcome measures, hindering a comprehensive understanding of the effectiveness. OBJECTIVES: To synthesize and evaluate the strength of evidence on the effectiveness of digital and telemedicine interventions for the management of gestational diabetes mellitus. DESIGN: An umbrella review of systematic reviews and meta-analyses. METHODS: We searched eleven databases from inception to 21 April 2026. Two reviewers independently screened studies, extracted data, and assessed methodological quality using A MeaSurement Tool to Assess systematic Reviews. Overlap was assessed using the corrected covered area. Data were synthesized narratively; random-effects meta-analyses were conducted for glycaemic outcomes using primary study data. The strength of evidence was categorized based on the consistency, magnitude of effect, and statistical significance of results across the included reviews. RESULTS: Twenty-four systematic reviews were identified, comprising 144 primary studies and 41,384 participants. Evidence synthesis showed a dual benefit: significant improvement in glycaemic control and reduction in key adverse outcomes. Meta-analyses demonstrated statistically significant benefits for: HbA1c (Mean Difference: - 0.72%, 95% CI: - 0.93 to - 0.51; weak positive evidence); fasting blood glucose (Mean Difference: - 0.70 mmol/L, 95% CI - 0.89 to - 0.50; weak positive); and 2-hour postprandial blood glucose (Mean Difference: - 1.19 mmol/L, 95% CI - 1.52 to - 0.85; strong positive). Significant benefits were also observed for maternal outcomes (premature rupture of membranes, polyhydramnios), delivery outcomes (normal vaginal delivery, cesarean delivery, shoulder dystocia), neonatal macrosomia, and gestational weight gain, all of which were graded as weak positive. Multi-component interventions and those delivered via social platforms yielded larger effects. Evidence for long-term maternal and offspring outcomes was limited. CONCLUSIONS: Digital and telemedicine interventions are effective for improving glycaemic control and reducing adverse pregnancy outcomes in gestational diabetes mellitus, with the strongest evidence for postprandial glucose reduction. Future implementation requires high-quality trials with extended follow-up and a focus on integrated, multi-component care models. REGISTRATION: This study was prospectively registered on PROSPERO (CRD420250649164).