Impact and duration effect of telemonitoring on ΗbA1c, BMI and cost in insulin-treated Diabetes Mellitus patients with inadequate glycemic control: A randomized controlled study

Fountoulakis, Stelios; Papanastasiou, Labrini; Gryparis, Alexandros; Markou, Αthina; Piaditis, George

doi:10.14310/horm.2002.1603

Cited by 28 publications

(38 citation statements)

References 38 publications

(44 reference statements)

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“…In the review by Tao et al, subgroup analysis did not show any significant differential effects among the intervention durations. Through short-term remote monitoring of diabetes, the patient's blood sugar control is ideal, but whether the benefits are significant or not, remains to be further studied (Aliha et al, 2013;Borhani et al, 2013;Fountoulakis et al, 2015;Kotsani et al, 2018;Solaiman, 2016).…”

Section: Summary Of the Main Resultsmentioning

confidence: 99%

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The role of telenursing in the management of diabetes：A systematic review and meta‐analysis

Yang

Jiang

2019

Public Health Nursing

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Background Diabetes is a common chronic disease that requires a long‐term regimen. However, the management of diabetes by telenursing is limited and inconclusive. Objectives To determine the effectiveness of telenursing on control in diabetes. We conducted a systematic review and meta‐analysis of randomized controlled trials (RCTs). Methods We searched electronic databases, including PubMed, Embase, Web of Science and Cochrane Library. Studies comparing telenursing with usual care in diabetes patients were included. Results A total of 17 randomized controlled trials were identified. Glycated hemoglobin (HbA1c) dates were pooled using a random effects meta‐analysis method, followed by subgroup analyses to examine heterogeneity. The meta‐analysis showed that the use of telenursing (vs. usual care) was associated with a significant reduction in HbA1c levels compared to usual care, with a pooled 0.68% (95% CI: 0.33–1.03, p = 0.0001; I2 = 95%). For the secondary outcome, the SMD of body mass index (BMI) was −0.25% (95% CI: −0.81 to 0.32%, p = 0.39), with no statistically significant change; the fasting blood sugar (FBS) SMD was −0.19% (95% CI: 0.20 to 1.01, p = 0.003), with a statistically significant change; the total cholesterol (TC) SMD was −0.09% (95% CI: −0.03 to 0.21, p = 0.12), with no statistically significant change. Conclusions Telenursing, as a useful tool for patient education and behavioral interventions, can help diabetes patients to improve their glycemic control. However, more studies on up‐to‐date and cost‐effective technologies are needed.

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Section: Summary Of the Main Resultsmentioning

confidence: 99%

“…Five studies (Aliha et al, 2013;Borhani et al, 2013;Fountoulakis, Papanastasiou, Gryparis, Markou, & Piaditis, 2015;Kotsani et al, 2018;Solaiman, 2016) examined FBS change after the intervention, and their finding can explain the insignificant difference (SMD = −0.19, 95% CI: 0.20-1.01, p = 0.003).…”

Section: Changes In Fbsmentioning

confidence: 99%

The role of telenursing in the management of diabetes：A systematic review and meta‐analysis

Yang

Jiang

2019

Public Health Nursing

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“…Результаты поиска и отбора публикаций В результате систематического поиска нами были найдены 274 ссылки на публикации по исследованиям телемедицинского дистанционного наблюдения пациентов с СД1 и СД2, из которых исключены 264 ссылки на публикации. Таким образом, для настоящего систематического обзора нами было отобрано 10 публикаций об РКИ [3][4][5][6][7][8][9][10][11][12].…”

Section: результатыunclassified

“…Характеристика отобранных публикаций 9 РКИ [3][4][5][7][8][9][10][11][12] изучали пациентов с СД2, 1 РКИ [6] пациентов с СД1 и СД2 (табл. 1).…”

Section: результатыunclassified

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A systematic review of the clinical effectiveness of monitoring patients with diabetes mellitus using individual blood glucose meters with function of transmitting measurements via gsm channel or via the internet

Fedyaeva¹,

Zhuravlev²,

Галеева³

2019

Diabetes mellitus

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BACKGROUND: In recent years, there has been an active introduction of telecommunication technologies in various spheres of scientific and practical knowledge, including medicine. Diabetes mellitus (DM) is one of the most common chronic non-communicable diseases requiring constant monitoring of the patients condition. For telemedicine monitoring of patients with DM, glucose self-monitoring devices with the option of transmitting patients measurements via GSM channel or via the Internet have been developed. AIM: To evaluate the clinical effectiveness of telemedicine observation of patients with DM using individual glucose self-monitoring devices with option of transmitting patients measurements via a GSM channel or via the Internet. MATERIALS AND METHODS: Publications about clinical trials were searched in PubMed. The search, selection and evaluation of the methodological quality of clinical trials were carried out by two independent researchers. Clinical trials were included in the review if the clinical efficacy of remote monitoring of patients with DM using individual glucose self-monitoring devices with the option of transmitting the results of measurements taken by the patient via a GSM channel or via the Internet was evaluated in comparison with traditional observation methods. RESULTS: As a result of the systematic search, 10 original randomized controlled trials (RCTs) with different methodological quality were selected. It was found that the use of remote technologies for 12 months does not affect the level of glycated hemoglobin, however, it allows to increase the frequency of achieving individual therapeutic goals in patients with type 2 DM. In addition, it was found that the use of remote technologies allows to reduce the frequency of outpatient visits of patients with type 2 DM, but does not reduce the length of hospitalization and the frequency of an emergency calls of these patients. CONCLUSION: Thus, evidence was obtained of the potential therapeutic benefits of remote observation of patients with diabetes based on data from foreign clinical studies. Based on the results obtained, a Russian clinical trial of this medical technology can be recommended.

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Quality improvement strategies for diabetes care: Effects on outcomes for adults living with diabetes

Yogasingam

Konnyu

Lépine

et al. 2023

Cochrane Database of Systematic Reviews

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Background There is a large body of evidence evaluating quality improvement (QI) programmes to improve care for adults living with diabetes. These programmes are often comprised of multiple QI strategies, which may be implemented in various combinations. Decision‐makers planning to implement or evaluate a new QI programme, or both, need reliable evidence on the relative effectiveness of different QI strategies (individually and in combination) for different patient populations. Objectives To update existing systematic reviews of diabetes QI programmes and apply novel meta‐analytical techniques to estimate the effectiveness of QI strategies (individually and in combination) on diabetes quality of care. Search methods We searched databases (CENTRAL, MEDLINE, Embase and CINAHL) and trials registers (ClinicalTrials.gov and WHO ICTRP) to 4 June 2019. We conducted a top‐up search to 23 September 2021; we screened these search results and 42 studies meeting our eligibility criteria are available in the awaiting classification section. Selection criteria We included randomised trials that assessed a QI programme to improve care in outpatient settings for people living with diabetes. QI programmes needed to evaluate at least one system‐ or provider‐targeted QI strategy alone or in combination with a patient‐targeted strategy. ‐ System‐targeted: case management (CM); team changes (TC); electronic patient registry (EPR); facilitated relay of clinical information (FR); continuous quality improvement (CQI). ‐ Provider‐targeted: audit and feedback (AF); clinician education (CE); clinician reminders (CR); financial incentives (FI). ‐ Patient‐targeted: patient education (PE); promotion of self‐management (PSM); patient reminders (PR). Patient‐targeted QI strategies needed to occur with a minimum of one provider or system‐targeted strategy. Data collection and analysis We dual‐screened search results and abstracted data on study design, study population and QI strategies. We assessed the impact of the programmes on 13 measures of diabetes care, including: glycaemic control (e.g. mean glycated haemoglobin (HbA1c)); cardiovascular risk factor management (e.g. mean systolic blood pressure (SBP), low‐density lipoprotein cholesterol (LDL‐C), proportion of people living with diabetes that quit smoking or receiving cardiovascular medications); and screening/prevention of microvascular complications (e.g. proportion of patients receiving retinopathy or foot screening); and harms (e.g. proportion of patients experiencing adverse hypoglycaemia or hyperglycaemia). We modelled the association of each QI strategy with outcomes using a series of hierarchical multivariable meta‐regression models in a Bayesian framework. The previous version of this review identified that different strategies were more or less effective depending on baseline levels of outco...

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Impact and duration effect of telemonitoring on ΗbA1c, BMI and cost in insulin-treated Diabetes Mellitus patients with inadequate glycemic control: A randomized controlled study

Abstract: Telemonitoring can result in reduction of HbA1c and frequency of hypo- and hyperglycemias. This beneficial effect is slightly attenuated 6 months after terminating telemonitoring.

Cited by 28 publications

References 38 publications

The role of telenursing in the management of diabetes：A systematic review and meta‐analysis

The role of telenursing in the management of diabetes：A systematic review and meta‐analysis

A systematic review of the clinical effectiveness of monitoring patients with diabetes mellitus using individual blood glucose meters with function of transmitting measurements via gsm channel or via the internet

Quality improvement strategies for diabetes care: Effects on outcomes for adults living with diabetes

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