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远程监测干预对 2 型糖尿病患者血糖控制效果的系统评价和荟萃分析。

Effectiveness of telemonitoring intervention on glycaemic control in patients with type 2 diabetes mellitus: A systematic review and meta-analysis.

机构信息

School of Medicine and Dentistry, Griffith University, Q4215, Australia.

School of Medicine and Dentistry, Griffith University, Q4215, Australia; Menzies Health Institute Queensland, Griffith University, Q4215, Australia; Department of Neurology, Gold Coast University Hospital, Q4222, Australia.

出版信息

Diabetes Res Clin Pract. 2023 Jul;201:110727. doi: 10.1016/j.diabres.2023.110727. Epub 2023 May 20.

Abstract

BACKGROUND

Type 2 diabetes mellitus (T2DM) is a rising global health concern that requires long-term treatment and close monitoring. Telemonitoring has been shown to be a promising tool to facilitate patient-physician interaction and improve glycaemic control.

METHOD

Randomised controlled trials (RCT) of telemonitoring in T2DM published between 1990 and 2021 were searched through multiple electronic databases. The primary outcome variables included HbA1c and fasting blood glucose (FBG), and BMI was a secondary outcome variable.

RESULTS

Thirty RCT with a total of 4,678 participants were included in this study. Twenty-six studies reported on HbA1c, which was shown to be significantly lower in participants on telemonitoring when compared to conventional care. Ten studies investigated FBG which collectively showed no statistically significant difference. Subgroup analysis demonstrated the effect of telemonitoring on glycaemic control is influenced by a range of factors concerning system practicality, user engagement, patient characteristics and disease education.

CONCLUSION

Telemonitoring exhibited a great potential to improve T2DM management. Several technical features and patient factors may influence the effectiveness of telemonitoring. Further studies are needed to verify the findings and address limitations before its implementation into routine practice.

摘要

背景

2 型糖尿病(T2DM)是一个日益受到全球关注的健康问题,需要长期治疗和密切监测。远程监测已被证明是促进医患互动和改善血糖控制的有前途的工具。

方法

通过多个电子数据库检索了 1990 年至 2021 年间发表的关于 T2DM 远程监测的随机对照试验(RCT)。主要结局变量包括 HbA1c 和空腹血糖(FBG),体重指数(BMI)是次要结局变量。

结果

本研究共纳入 30 项 RCT,共 4678 名参与者。26 项研究报告了 HbA1c,结果表明远程监测组的 HbA1c 明显低于常规护理组。10 项研究调查了 FBG,总体上没有统计学意义的差异。亚组分析表明,远程监测对血糖控制的影响受到系统实用性、用户参与度、患者特征和疾病教育等一系列因素的影响。

结论

远程监测在改善 T2DM 管理方面显示出巨大的潜力。一些技术特点和患者因素可能会影响远程监测的效果。在将其纳入常规实践之前,需要进一步研究来验证这些发现并解决其局限性。

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