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 A<sub>1c</sub> (HbA<sub>1c</sub>) 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 HbA<sub>1c</sub>, 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 HbA<sub>1c</sub>, suitable RCTs were pooled and the average was determined. An HbA<sub>1c</sub> decrease of –1.15% (95% CI –1.84% to –0.45%), yielding an HbA<sub>1c</sub> value of 6.95% (SD 0.495), was shown in studies using 6-month “real-time video” interventions.
CONCLUSIONS
Telemetric interventions clearly improve HbA<sub>1c</sub> 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.