Efficacy of telemedicine on glycaemic control in patients with type 2 diabetes:A meta-analysis

• 作者: Declan Flynn Dongjun Wu Dylan Robertson Gary Grant Jing Sun Julia De Groot
• 来源期刊: 世界糖尿病杂志:英文版(电子版)
• 学科: 医学
• 关键词: TELEHEALTH TELEMEDICINE TELEMONITORING Behavioural change Selfmanagement DIABETES
• 年，卷（期）: 2021,（2）
• 页码范围: 170-197
• 页数: 28页
• 分类号: R58

摘要

BACKGROUND Telemedicine is defined as the delivery of health services via remote communication and technology.It is a convenient and cost-effective method of intervention,which has shown to be successful in improving glyceamic control for type 2 diabetes patients.The utility of a successful diabetes intervention is vital to reduce disease complications,hospital admissions and associated economic costs.AIM To evaluate the effects of telemedicine interventions on hemoglobin A1c(HbA1c),systolic blood pressure(SBP),diastolic blood pressure(DBP),body mass index(BMI),post-prandial glucose(PPG),fasting plasma glucose(FPG),weight,cholesterol,mental and physical quality of life(QoL)in patients with type 2 diabetes.The secondary aim of this study is to determine the effect of the following subgroups on HbA1c post-telemedicine intervention;telemedicine characteristics,patient characteristics and self-care outcomes.METHODS PubMed Central,Cochrane Library,Embase and Scopus databases were searched from inception until 18th of June 2020.The quality of the 43 included studies were assessed using the PEDro scale,and the random effects model was used to estimate outcomes and I2 for heterogeneity testing.The mean difference and standard deviation data were extracted for analysis.RESULTS We found a significant reduction in HbA1c[-0.486%;95%confidence interval(CI)-0.561 to-0.410,P<0.001],DBP(-0.875 mmHg;95%CI-1.429 to-0.321,P<0.01),PPG(-1.458 mmol/L;95%CI-2.648 to-0.268,P<0.01),FPG(-0.577 mmol/L;95%CI-0.710 to-0.443,P<0.001),weight(-0.243 kg;95%CI-0.442 to-0.045,P<0.05),BMI(-0.304;95%CI-0.563 to-0.045,P<0.05),mental QoL(2.210;95%CI 0.053 to 4.367,P<0.05)and physical QoL(-1.312;95%CI 0.545 to 2.080,P<0.001)for patients following telemedicine interventions in comparison to control groups.The results of the meta-analysis did not show any significant reductions in SBP and cholesterol in the telemedicine interventions compared to the control groups.The telemedicine characteristic subgroup analysis revealed that clinical treatment models o