Meta-Analysis of the Effect of Internet-Based Self- Management on Blood Glucose Control in Type 2 Diabetes Mellitus Patients (original) (raw)
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Journal of education and health promotion, 2022
Abstract: BACKGROUND: Type 2 diabetes (T2DM) decreases the life expectancy and quality of life of diabetics and causes economic and societal problems. For this purpose, diabetes self‑management education and support (DSMES) has been designed for many years, which is recently provided through technology‑assisted education. Therefore, we developed a web‑based program in accordance with DSMES to assess its effect on self‑care behaviors and glycated hemoglobin (HbA1c) for patients with T2DM during the coronavirus disease (COVID‑19) pandemic, which is described in detail in this paper. MATERIALS AND METHODS: This randomized controlled trial (RCT) was performed on 70 diabetic patients in Al‑Zahra Hospital for three months. After random allocation, web‑based educational content (including videos, lectures, educational motion graphics, text fles, educational posters, and podcasts) according to DSMES was provided for the intervention group to improve self‑care behaviors and HbA1c levels. The control group received routine educational pamphlets. A diabetes self‑management questionnaire (21 questions) with a Likert scale was completed to assess self‑care behaviors scores before and after intervention and three months later. Also, HbA1c was determined before and after the intervention. Analysis of variance with repeated measurements will be applied to compare mean scores of self‑care behaviors components three times, and an independent t‑test analyzed mean differences of HbA1c values. CONCLUSION: The obtained results of this study might be useful for promoting self‑care behaviors and assessing HbA1c in diabetic patients. Keywords: Glycated hemoglobin A1c, self‑care, type 2 diabetes, web‑based interventions
Journal of medical Internet research, 2016
Information technology-based interventions are increasingly being used to manage health care. However, there is conflicting evidence regarding whether these interventions improve outcomes in people with type 2 diabetes. The objective of this study was to conduct a systematic review and meta-analysis of clinical trials, assessing the impact of information technology on changes in the levels of hemoglobin A1c (HbA1c) and mapping the interventions with chronic care model (CCM) elements. Electronic databases PubMed and EMBASE were searched to identify relevant studies that were published up until July 2016, a method that was supplemented by identifying articles from the references of the articles already selected using the electronic search tools. The study search and selection were performed by independent reviewers. Of the 1082 articles retrieved, 32 trials (focusing on a total of 40,454 patients) were included. A random-effects model was applied to estimate the pooled results. Inform...
Effectiveness E-Health to Self Management of Diabetes Mellitus Type 2 : Literature Review
Indonesian Journal of Community Health Nursing, 2022
Introduction: Patient and nurse is constructive relationship beneficial in a selfmanagement support approach. Research shows e-health intervention has the potential to support self-management for adults with type 2 diabetes. The purpose this article to apply the application of e-health to people with type 2 diabetes mellitus. Method: Method is search journal articles through basic data in ProQuest, Clinical key, EBSCO with a time span of 2018-2022, using the keywords "e-health intervention" and "diabetes mellitus type 2". The number of related articles is 10 journals. Results: Results the literature review conducted showed that e-health has an effective and efficient impact on self-management in patients with type 2 diabetes mellitus, nurses can find time to find out the progress of people with diabetes mellitus, reduce the incidence of diabetes and complications. Conclusion: Conclusion the use of e-health in self-management of people with diabetes mellitus has provided positive benefits for the development and improvement of service quality for the community. Health is a new medium in health services that requires broader knowledge and more in-depth practice, so the use of digital media in management needs to conduct further research in the focus of research on health.
JMIR Research Protocols, 2017
Background: Little attention has been paid to self-management support of patients with well-controlled type 2 diabetes mellitus (T2DM). Most studies evaluated the addition of self-management support to regular diabetes care, but self-management as an alternative for part of regular diabetes care has hardly been studied. In this study, we offered patients with well-controlled T2DM the opportunity to perform the 3 quarterly monitoring sessions at home using an Internet-based self-management program, resulting in online personalized advice. Objective: The aim of our study was to assess the reach and feasibility of an Internet-based diabetes self-management support program for patients with well-controlled T2DM, addressing both primary care providers' (PCPs) opinions and patients' willingness to participate in such a support program. Methods: PCPs assessed patients' eligibility for Internet-based self-management, and patients were offered the opportunity to participate. Characteristics of eligible and ineligible patients were compared, as well as those of participants and nonparticipants, also with regard to quality of life, treatment satisfaction, and illness perceptions. Multivariate logistic regression models were performed and odds ratios (ORs) calculated with 95% CIs. Results: Almost half (128/282, 45.4%) of the patients with well-controlled T2DM were considered ineligible by their PCPs mainly because of cognitive impairment and language barriers (8.2% and 8.9%). Older patients (OR for each year 1.06, 95% CI 1.03-1.09, P<.001), non-Western European patients (OR 3.64, 95% CI 1.67-7.92, P=.001), and patients with a longer diabetes duration (OR for each year 1.56, 95% CI 1.04-2.34, P=.03) were more often regarded as ineligible. Of the 154 patients considered eligible, 57 (37.0%) consented to participate and 30 (10.6%) started the program. Of 57 participants, 45 returned the 3 questionnaires; 21 of 97 nonparticipants returned the questionnaires. Nonparticipants less often thought that their disease would last their entire life (median 8.0 vs 10.0, P=.03) and they were more satisfied with their current treatment than participants (DTSQ total score 44.0 vs 40.0, P=.05). There was no significant difference in quality of life between the 2 groups. Conclusions: PCPs considered half of their patients with well-controlled T2DM incapable of Internet-based self-management mainly because of cognitive impairment and language barriers; of the selected patients, about 1 out of 3 was willing to participate. Older patients, non-Western European patients, and patients with a higher BMI were less likely to participate. Predominantly, practical issues (such as Internet problems) hindered implementation of the Internet-based self-management program.
Shiraz E-Medical Journal, 2018
To determine the role of electronic health (e-health) in the management of diabetes mellitus (DM), systematic review (SR) and metaanalysis (MA) studies were searched systematically. Eleven SR and six MA studies, including 533 sub-articles, were finally assessed. Six articles studied type 2, two studies assessed type 1, and five studies focused on both types of DM while four studies included type 1, type 2, and gestational DM. In total, 38641 patients with DM from all age groups were studied with a follow-up time from two phone calls to 60 months. As an intervention, short message service, multimedia messaging service, telemonitoring, glucometer applications, and personal digital assistant tools were studied. Nine out of 17 studies (53%) showed a significant reduction in HbA1c and eight (47%) studies revealed the inconclusive effect on it. However, the first group of studies was stronger and among interventions, text messaging as reminders was more effective. Conclusively, the majority of evidence shows the improvement of DM management by using e-health. However, a fragile acceptance toward this issue existed. Therefore, future research should focus more on using standard tools for the assessment of e-health efficacy, patients' views, health care providers' opinions, and cost-effectiveness of such interventions in long term.
International Journal of Medical Informatics, 2011
The Internet has emerged as a potentially effective medium for information exchange. The Internet's potential has been recognised and web-based education programmes have been steadily adopted in recent years in preventing and managing chronic diseases such as diabetes mellitus. This review provides a descriptive discussion of web-based behavioural interventions for the management of type 2 diabetes mellitus.Systematic literature searches were performed using MEDLINE, EMBASE, PUBMED, PsycINFO, Web of Science and Cochrane Library to retrieve articles published between 2000 and June 2010 which fulfilled all inclusion criteria. Methodological quality assessment and data synthesis were then performed.Twenty articles representing 13 different studies were reviewed. None of the studies were ranked as low in the methodological quality. Goal-setting, personalised coaching, interactive feedback and online peer support groups were some of the successful approaches which were applied in e-interventions to manage type 2 diabetes mellitus. Strong theoretical background, use of other technologies and longer duration of intervention were proven to be successful strategies as well.The web-based interventions have demonstrated some level of favourable outcomes, provided they are further enhanced with proper e-research strategies.► We reviewed 13 web-based behavioural interventions for the management of type 2 diabetes. ► Goal-setting, personalisation, interactivity and peer support were successful approaches. ► We find the use of other technologies, theory and longer study duration to be good strategies. ► We suggest these approaches and strategies to be applied in future web-based interventions.
Online Diabetes Self-Management Program: A randomized study
Diabetes Care, 2010
OBJECTIVE -We hypothesized that people with type 2 diabetes in an online diabetes self-management program, compared with usual-care control subjects, would 1) demonstrate reduced A1C at 6 and 18 months, 2) have fewer symptoms, 3) demonstrate increased exercise, and 4) have improved self-efficacy and patient activation. In addition, participants randomized to listserve reinforcement would have better 18-month outcomes than participants receiving no reinforcement.
Journal of the American Medical Informatics Association
Objective: The purpose of this systematic review and meta-analysis was to examine the effect of health information technology (HIT) diabetes self-management education (DSME) interventions on glycemic control in medically underserved patients. Materials and Methods: Following an a priori protocol, 5 databases were searched. Studies were appraised for quality using the Cochrane Risk of Bias assessment. Studies reporting either hemoglobin A1c pre- and post-intervention or its change at 6 or 12 months were eligible for inclusion in the meta-analysis using random effects models. Results: Thirteen studies met the criteria for the systematic review and 10 for the meta-analysis and represent data from 3257 adults with diabetes (mean age 55 years; 66% female; 74% racial/ethnic minorities). Most studies (n = 10) reflected an unclear risk of bias. Interventions varied by HIT type: computer software without Internet (n = 2), cellular/automated telephone (n = 4), Internet-based (n = 4), and tele...