Open AccessEffect of Telemetric Interventions on Glycated Hemoglobin A1c and Management of Type 2 Diabetes Mellitus: Systematic Meta-Review
Author(s) -
Claudia Eberle,
Stefanie Stichling
Publication year - 2021
Publication title -
jmir. journal of medical internet research/journal of medical internet research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.446
H-Index - 142
eISSN - 1439-4456
pISSN - 1438-8871
DOI - 10.2196/23252
Subject(s) - medicine , psychological intervention , glycated hemoglobin , cinahl , systematic review , meta analysis , cochrane library , randomized controlled trial , type 2 diabetes mellitus , medline , observational study , diabetes mellitus , intensive care medicine , type 2 diabetes , physical therapy , nursing , endocrinology , political science , law
Background Diabetes mellitus is a chronic burden, with a prevalence that is increasing worldwide. Telemetric interventions have attracted great interest and may provide effective new therapeutic approaches for improving type 2 diabetes mellitus (T2DM) care. Objective The objective of this study was to analyze the clinical effectiveness of telemetric interventions on glycated hemoglobin A 1c (HbA 1c ) specifically and T2DM management generally in a systematic meta-review. Methods A systematic literature search was performed in PubMed, CINAHL, Cochrane Library, Web of Science Core Collection, and EMBASE databases from January 2008 to April 2020. Studies that addressed HbA 1c , blood pressure, fasting blood glucose, BMI, diabetes-related and health-related quality of life, cost-effectiveness, time savings, and the clinical effectiveness of telemetric interventions were analyzed. In total, 73 randomized controlled trials (RCTs), 10 systematic reviews/meta-analyses, 9 qualitative studies, 2 cohort studies, 2 nonrandomized controlled studies, 2 observational studies, and 1 noncontrolled intervention study were analyzed. Results Overall, 1647 citations were identified. After careful screening, 99 studies (n=15,939 patients; n=82,436 patient cases) were selected by two independent reviewers for inclusion in the review. Telemetric interventions were categorized according to communication channels to health care providers: (1) “real-time video” interventions, (2) “real-time audio” interventions, (3) “asynchronous” interventions, and (4) “combined” interventions. To analyze changes in HbA 1c , suitable RCTs were pooled and the average was determined. An HbA 1c decrease of –1.15% (95% CI –1.84% to –0.45%), yielding an HbA 1c value of 6.95% (SD 0.495), was shown in studies using 6-month “real-time video” interventions. Conclusions Telemetric interventions clearly improve HbA 1c values in both the short term and the long term and contribute to the effective management of T2DM. More studies need to be done in greater detail.