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 A1c (HbA1c) 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 HbA1c, 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 HbA1c, suitable RCTs were pooled and the average was determined. An HbA1c decrease of –1.15% (95% CI –1.84% to –0.45%), yielding an HbA1c value of 6.95% (SD 0.495), was shown in studies using 6-month “real-time video” interventions. Conclusions: Telemetric interventions clearly improve HbA1c 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.

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中文翻译：

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遥测干预对糖化血红蛋白A1c和2型糖尿病管理的影响：系统的Meta审查。

背景：糖尿病是一种长期负担，全世界的患病率正在增加。遥测干预已经引起了极大的兴趣，并可能为改善2型糖尿病（T2DM）护理提供有效的新治疗方法。目的：本研究的目的是通过系统的荟萃分析来分析遥测干预对糖化血红蛋白A1c（HbA1c）的临床有效性以及总体上对T2DM管理的有效性。方法：从2008年1月至2020年4月在PubMed，CINAHL，Cochrane图书馆，Web of Science核心收藏和EMBASE数据库中进行了系统的文献检索。研究涉及HbA1c，血压，空腹血糖，BMI，糖尿病相关和健康相关的生活质量，成本效益，节省时间，并分析了遥测干预的临床效果。总共分析了73项随机对照试验（RCT），10项系统评价/元分析，9项定性研究，2项队列研究，2项非随机对照研究，2项观察性研究和1项非对照干预研究。结果：总体上，确定了1647次被引用。经过仔细筛选，两名独立审阅者选择了99项研究（n = 15,939例患者； n = 82,436例患者病例）纳入了本评价。遥测干预根据与医疗保健提供者的通信渠道进行了分类：（1）“实时视频”干预，（2）“实时音频”干预，（3）“异步”干预和（4）“组合”干预。为了分析HbA1c的变化，汇集了合适的RCT，并确定了平均值。在使用6个月“实时视频”干预的研究中显示，HbA1c下降了–1.15％（95％CI从–1.84％下降到–0.45％），HbA1c值为6.95％（SD 0.495）。结论：遥测干预可以在短期和长期内显着提高HbA1c值，并有助于有效管理T2DM。需要更详细地进行更多的研究。

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