Effect of smartphone apps on glycemic control in young patients with type 1 diabetes: A meta-analysis.
Effect of smartphone apps on glycemic control in young patients with type 1 diabetes: A meta-analysis.
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DOI：
10.3389/fpubh.2023.1074946
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发表时间：
2023
影响因子：
5.2
通讯作者：
Zhou, Zhiguang
中科院分区：
文献类型：
--
作者：
Pi, Linhua;Shi, Xiajie;Wang, Zhen;Zhou, Zhiguang
实现血糖控制是1型糖尿病（T1 D）年轻患者面临的巨大挑战，特别是在从儿童到成年的过渡期间。由于已经开发了各种智能手机应用程序来改善T1 D的血糖控制，我们对随机对照试验进行了荟萃分析，以评估智能手机应用程序对年轻T1 D患者血糖控制的影响。我们系统地检索了PubMed、Embase和科克伦图书馆，以寻找比较常规护理和智能手机应用程序联合治疗与单独常规护理的随机对照试验。本荟萃分析按照系统性综述和荟萃分析首选报告项目（PRISMA）声明进行报告。主要结局是干预组和对照组之间HbA 1c较基线变化的加权平均差异（WMD）和轻度低血糖或重度低血糖的人-年发生率。我们使用随机效应模型评估了汇总数据。在1，190项确定的研究中，有9项符合条件并纳入我们的分析（N = 748例受试者）。与对照组相比，使用智能手机应用程序导致糖化血红蛋白（HbA 1c）无显著降低（WMD = −0.26，95% CI：−0.56至0.05; p = 0.10），轻度低血糖的发生频率未增加（WMD = 1.87，95% CI：-1.52至5.27; p = 0.49）或重度低血糖（WMD =-0.04，95% CI：-0.35至0.27; p = 0.80）。在进一步的亚组分析中，与记录式应用程序组相比，笔记本式应用程序组的HbA 1c显著降低（WMD =-0.83，95%CI：-1.10 to-0.56，p < 0.001）。目前的汇总数据分析并未显示，接受智能手机应用程序和常规护理联合治疗的年轻T1 D患者的HbA 1c显著降低。然而，带有胰岛素或碳水化合物计算器的电子式应用程序有利于降低HbA 1c。
Achieving glycemic control is a great challenge for young patients with type 1 diabetes (T1D), especially during the transition from childhood to adulthood. As various smartphone apps have been developed to improve glycemic control in T1D, we performed a meta-analysis of randomized controlled trials to assess the effect of smartphone apps on glycemic control in young patients with T1D. We systematically searched PubMed, Embase, and the Cochrane Library for randomized controlled trials comparing combined usual care and smartphone app treatment to usual care alone. This meta-analysis is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. The primary outcomes were the weighted difference in means (WMD) of HbA1c change from baseline and the person-years incidence of mild hypoglycemia or severe hypoglycemia between intervention and control groups. We assessed pooled data by use of a random-effects model. Of 1,190 identified studies, nine were eligible and included in our analysis (N = 748 participants). Relative to the control, using smartphone apps yielded a non-significant reduction in glycated hemoglobin (HbA1c) (WMD = −0.26, 95% CI: −0.56 to 0.05; p = 0.10) and no increased frequency of mild hypoglycemia (WMD = 1.87, 95% CI: −1.52 to 5.27; p = 0.49) or severe hypoglycemia (WMD = −0.04, 95% CI: −0.35 to 0.27; p = 0.80). In further subgroup analysis, compared with the recording-style app group, the auxiliary-style app group exhibited a significant reduction in HbA1c (WMD = −0.83, 95% CI: −1.10 to −0.56, p < 0.001). The current pooled data analysis did not reveal a significant reduction in HbA1c in young patients with T1D undergoing treatment with smartphone apps and usual care in combination. However, auxiliary-style apps with insulin or carbo calculators were beneficial in reducing HbA1c.
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16.2
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