Effect of Health Information Technologies on Glycemic Control Among Patients with Type 2 Diabetes

Abstract

Purpose of ReviewThis study was to present meta-analysis findings across selected clinical trials for the effect of health information technologies (HITs) on glycemic control among patients with type 2 diabetes.Recent FindingsHITs may be promising in diabetes management. However, findings on effect size of glycated hemoglobin level (HbA1c) yielded from HITs varied across previous studies. This is likely due to heterogeneity in sample size, adherence to standard quantitative method, and/or searching criteria (e.g., type of HITs, type of diabetes, specification of patient population, randomized vs. nonrandomized trials).SummaryWe systematically searched Medline, Cumulative Index of Nursing and Allied Health Literature (CINAHL), and the Cochrane Library for peer-reviewed randomized control trials that studied the effect of HITs on HbA1c reduction. We also used Google Scholar and a hand search to identify additional studies. Thirty-four studies (40 estimates) met the criteria and were included in the analysis. Overall, introduction of HITs to standard diabetes treatment resulted in a statistically and clinically reduced HbA1c. The bias adjusted HbA1c reduction due to the combined HIT interventions was − 0.56 [Hedges’ g = − 0.56 (− 0.70, − 0.43)]. The reduction was significant across each of the four types of HIT intervention under review, with mobile phone-based approaches generating the largest effects [Hedges’ g was − 0.67 (− 0.90, − 0.45)]. HITs can be an effective tool for glycemic control among patients with type 2 diabetes. Future studies should examine long-term effects of HITs and explore factors that influence their effectiveness.Electronic supplementary materialThe online version of this article (10.1007/s11892-018-1105-2) contains supplementary material, which is available to authorized users.

Health Information Technologies in Diabetes Management

“…usual care [33]. This result suggests that HITs are the key to the effectiveness rather than tools or components of these trials.…”

“…However, these studies often included limited number of trials [21], lack of adherence to standard quantitative methods [25], inadequate attention to heterogeneity across studies [26], lumped nonrandomized and randomized trials together into evaluation [19,23,25,[27][28][29], mixed participants with type 1 or type 2 diabetes into analysis [18,22,25,[27][28][29], or restricted searching criteria to a particular patient population or a specific type of HIT [27,[30][31][32]. To address these limitations and to verify if and how much HITs impact glycemic control, Yoshida and colleagues recently conducted a meta-analysis to examine the most current state of evidence from RCTs concerning the effect of HITs on HbA1c reduction among patients with T2D [33]. From an analysis of 34 eligible studies (40 estimates) identified from multiple databases from January 1946 to December 2017, the study reported that introduction of HITs to standard diabetes treatment resulted in a statistically reduced HbA1c.…”

“…It is questionable that the effects on HbA1c yielded from the HIT trials were a mixed product of both HITs and standard diabetes care including medication adherence and lifestyle modifications. This concern was addressed in the systematic review of Yoshida et al [33]. The authors conducted a subset analysis of 18 studies that exclusively compared the outcome between a combined HITs and standard care intervention group vs. standard care control group.…”

“…The effect size estimated from this analysis was −0.63 (Hedges' g: −0.63 95% CI −0.84, −0.42), which is attributable to HIT tools in addition to the Pooled reduction of HbA1c due to HITs. Adopted from the study of Yoshida et al [33].…”

An IoT-Based Glucose Monitoring Algorithm to Prevent Diabetes Complications

“…However, policies and regulations are necessary for privacy and security issues [28]. A study using health information technologies on glycemic control with type 2 diabetes was considered in [29] reporting better control both clinically and statistically. A reduction of HbA1c was observed in all the interventions presented.…”