User experiences and perceptions on the use of digital health technologies in the management of type 2 diabetes: an integrative systematic review

Introduction: Type 2 diabetes mellitus (T2DM) represents a global public health problem. In Ecuador, it is the second leading cause of death among women and the third among men. Digital health technologies, including mobile applications, messaging platforms, and web-based tools, have emerged as promising interventions for managing this condition, although a gap remains between their theoretical potential and their effective implementation in clinical practice. Objective: To explore and synthesize the available evidence on the experiences, perceptions, barriers, and facilitators reported by adult users with type 2 diabetes mellitus regarding the use of digital health technologies for managing their disease in community or outpatient settings. Methodology: An integrative systematic review of literature published between 2015 and 2025 was conducted in PubMed, Scopus, and Google Scholar. Qualitative, quantitative, and mixed-methods studies in English and Spanish involving adults using mobile applications for T2DM were included. Methodological quality was assessed using the Johns Hopkins Evidence-Based Practice model. Results: A total of 66 studies were analyzed, with qualitative designs predominating (n=28), followed by randomized clinical trials (n=13) and experimental studies (n=14). Most studies were rated as high (n=35) or good quality (n=28). Experiences were grouped into three categories: positive (usefulness, satisfaction, empowerment, educational support), conditioning factors (individual, contextual, and design-related), and barriers (technological, usability, personal). Perceptions focused on usefulness, usability, and impact on self-care. Facilitators included simple design, personalization, professional support, cultural adequacy, and motivation. Conclusions: Digital health technologies promote self-management and glycemic control, although barriers persist that limit their sustained adoption. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier CRD420251241989.