Digital health in managing type 2 diabetes among indigenous populations: a scoping review

Indigenous peoples have long demonstrated resilience and holistic approaches to health, grounded in cultural practices and community knowledge. Despite this, Indigenous populations globally experience a disproportionately high burden of Type 2 Diabetes Mellitus (T2DM). Existing healthcare models often fail to address the cultural, social, and structural determinants that influence health outcomes in these communities. Digital health technologies are increasingly recognised as valuable solutions to improve diabetes care, particularly in remote and underserved Indigenous settings.

This scoping review aimed to identify digital health technologies used in the treatment and management of T2DM among Indigenous populations, assess how ethical considerations are integrated into these interventions, and evaluate their effectiveness using the Quintuple Aim framework.

A systematic search of five electronic databases was conducted for studies published between 2010 and 2024. Eligible studies included primary research involving Indigenous populations with T2DM and digital health interventions directly engaging patients. Data were synthesised using qualitative content analysis, with interventions categorised according to the WHO digital health classification, NHMRC ethical guidelines, and the Quintuple Aim framework.

Mobile applications, remote monitoring devices, telemedicine, SMS/online messaging, and websites were the most used technologies. Interventions primarily supported targeted communication and health tracking. Ethical practices were evident across all research phases, with strong alignment to NHMRC values, particularly Respect and Reciprocity. While all studies reported positive impacts on at least one outcome, mixed results were observed across the Quintuple Aim domains. Patient experience was the most frequently and positively impacted domain, whereas cost and care team satisfaction were least addressed.

Digital health interventions demonstrate potential to improve diabetes care among Indigenous populations, particularly when culturally tailored and community led. However, further research is needed to assess long-term effectiveness, economic impact, and equitable access. Future initiatives should prioritise ethical engagement, Indigenous data sovereignty, and inclusive design to ensure sustainable and culturally appropriate digital health solutions.