Web-Based Remote Monitoring Systems for Self-Managing Type 2 Diabetes: A Systematic Review

Abstract

This systematic review aims to evaluate evidence for viability and impact of Web-based telemonitoring for managing type 2 diabetes mellitus. A review protocol included searching Medline, EMBASE, CINAHL, AMED, the Cochrane Library, and PubMed using the following terms: telemonitoring, type 2 diabetes mellitus, self-management, and web-based Internet solutions. The technology used, trial design, quality of life measures, and the glycated hemoglobin (HbA1c) levels were extracted. This review identified 426 publications; of these, 19 met preset inclusion criteria. Ten quasi-experimental research designs were found, of which seven were pre-posttest studies, two were cohort studies, and one was an interrupted time-series study; in addition, there were nine randomized controlled trials. Web-based remote monitoring from home to hospital is a viable approach for healthcare delivery and enhances patients' quality of life. Six of these studies were conducted in South Korea, five in the United States, three in the United Kingdom, two in Taiwan, and one each in Spain, Poland, and India. The duration of the studies varied from 4 weeks to 18 months, and the participants were all adults. Fifteen studies showed positive improvement in HbA1c levels. One study showed high acceptance of the technology among participants. It remains challenging to identify clear evidence of effectiveness in the rapidly changing area of remote monitoring in diabetes care. Both the technology and its implementations are complex. The optimal design of a telemedicine system is still uncertain, and the value of the real-time blood glucose transmissions is still controversial.

Diabetes and data in many forms

“…The Gather system, built on behavioral change theories to support self-management and to improve communication with physicians, resulted in improved A1c levels, similar to an earlier study reported by Shetty et al [10]. A systematic review on web-based remote monitoring systems in the self-management of type 2 diabetes concluded that there is complexity involved in the technology as well as in its implementation [11]. These must be addressed.…”

Impact of Information Technology–Based Interventions for Type 2 Diabetes Mellitus on Glycemic Control: A Systematic Review and Meta-Analysis

“…Several systematic reviews evaluated the potential benefits of information technology–based diabetes management interventions, and all concluded that information technology–based interventions could improve diabetes management for adult care [7-11]. However, they did not extend their focus to consider blood glucose measurements using meta-analysis techniques or map interventions incorporating CCM elements.…”

Telemedicine support to patients with chronic diseases for better long-term control at home

“…Several approaches have been reported in the literature that is available on setting-up a telemedicine service to support patients at home (9,15,16). They differ from one medical discipline to another by using different methods and tools.…”

“…Remote monitoring in CHF patient management may have a significant protective clinical effect on patients in comparison with those receiving regular care (7). Similarly, studies of remote monitoring in DM2 patients show positive effects e.g.an improvement (lowering) in HbA1c levels (8,9). JaVno ZdraVstVo (VarstVo pri deLu) …”