Dataset Information

Smartphones and Apps to Control Glycosylated Hemoglobin (HbA1c) Level in Diabetes: A Systematic Review and Meta-Analysis.

ABSTRACT: INTRODUCTION:Diabetes mellitus is a chronic endocrine-metabolic disease, the evolution of which is closely related to people´s self-control of glycemic levels through nutrition, exercise, and medicines. AIM:To determine whether smartphone apps can help persons with diabetes to improve their % levels of glycosylated hemoglobin. METHOD:A systematic review and meta-analysis were done. ProQuest, Pubmed/Medline, and Scopus databases were used. The search equation used was "(Prevention and Control) AND Diabetes Mellitus AND Smartphones". The inclusion criteria applied were clinical trials, conducted in 2014-2019. RESULTS:n = 18 studies were included in the review. The studies tried different applications to monitor glycemia and support patients to improve glycosylated hemoglobin (HbA1c) levels. More than half of the studies found statistically significant differences in HbA1c in the intervention group compared with the control group. Eleven studies were included in the meta-analysis and the study sample was n = 545 for the experimental group and n = 454 for the control group. The meta-analytic estimation of the HbA1c % level means differences between intervention and control group was statistically significant in favour of the intervention group with a mean difference of -0.37 (-0.58, -0.15. 95% confidence interval). CONCLUSION:Smartphone apps can help people with diabetes to improve their level of HbA1c, but the clinical impact is low.

SUBMITTER: Martos-Cabrera MB

PROVIDER: S-EPMC7141208 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Smartphones and Apps to Control Glycosylated Hemoglobin (HbA1c) Level in Diabetes: A Systematic Review and Meta-Analysis.

Martos-Cabrera María Begoña MB Velando-Soriano Almudena A Pradas-Hernández Laura L Suleiman-Martos Nora N Cañadas-De la Fuente Guillermo A GA Albendín-García Luis L Gómez-Urquiza José L JL

Journal of clinical medicine 20200304 3

<h4>Introduction</h4>Diabetes mellitus is a chronic endocrine-metabolic disease, the evolution of which is closely related to people´s self-control of glycemic levels through nutrition, exercise, and medicines.<h4>Aim</h4>To determine whether smartphone apps can help persons with diabetes to improve their % levels of glycosylated hemoglobin.<h4>Method</h4>A systematic review and meta-analysis were done. ProQuest, Pubmed/Medline, and Scopus databases were used. The search equation used was "(Prev ...[more]

PMID: 32143452

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Project description:Delay in commencing insulin among type 2 Diabetes Mellitus (DM) patients is common. One of the reasons is patients' psychological insulin resistance, which is particularly prevalent in Chinese patients. This study examined the correlation between socio-demographic and clinical characteristics; and attitudes towards commencing insulin in Chinese primary care patients.A cross-sectional survey was conducted on 303 insulin-naïve Type 2 DM patients recruited from 15 primary care clinics across Hong Kong using the Chinese Attitudes to Starting Insulin Questionnaire (Ch-ASIQ). Subject selection criteria were patients on maximal oral anti-diabetes treatment who needed to commence insulin therapy. Linear regression was used to identify correlations between age, sex, educational level, occupation, body mass index, diabetes disease duration, laboratory test indicating disease control and biochemical markers including glycosylated hemoglobin (HbA1c) level, low density lipoprotein level and estimated glomeruli filtration rate, and presence of diabetic complications with the four sub-scales (self-image and stigmatization; factors promoting self-efficacy; fear of pain or needles; time and family support ) and the overall Ch-ASIQ score.The most prevalent negative attitude was 'fear of needle injections' (70.1 %). The most common positive attitude was 'I can manage the skill of injecting insulin' (67.5 %). The mean Ch-ASIQ score of 2.50 (S.D. = 0.38) was equal to the mid-score, which signified an overall ambivalent attitude among the study population. Women scored significantly higher in the fear of pain or needles subscale (p = 0.011) and had an overall more negative attitude towards commencing insulin (p = 0.016). Subjects with lower HbA1c levels also had a significantly lower Ch-ASIQ sum score (p = 0.048) indicating a more negative attitude towards commencing insulin.In Chinese primary care patients with Type 2 DM, the need to commence insulin was associated with a number of negative emotions, which lead to a lower motivation to accept treatment. Perception of need as indicated by HbA1c level may be an important influencing factor determining a patient's overall attitude towards starting insulin. Fortunately, in our setting, the injection technique does not appear to be a major barrier. However, needle fears are common, especially amongst women. Target interventions to acknowledge and help them to overcome their fears are essential before insulin treatment is commenced.

Project description:BackgroundAir pollution exposures have been shown to adversely impact health through a number of biological pathways associated with glucose metabolism. However, few studies have evaluated the associations between air pollution and glycosylated hemoglobin (HbA1c) levels. Further, no studies have evaluated these associations in US populations or investigated whether associations differ in diabetic as compared to non-diabetic populations. To address this knowledge gap, we investigated the associations between airborne fine particulate matter (PM2.5) and nitrogen dioxide (NO2) and HbA1c levels in both diabetic and non-diabetic older Americans. We also examined the impact of PM2.5 and NO2 on prevalent diabetes mellitus (DM) in this cohort.MethodsWe used multilevel logistic and linear regression models to evaluate the association between long-term average air pollutant levels and prevalence of DM and HbA1c levels, respectively, among 4121 older (57+ years) Americans enrolled in the National Social Life, Health, and Aging Project between 2005 and 2011. All models adjusted for age, sex, body mass index, smoking status, race, household income, education level, neighborhood socioeconomic status, geographic region, urbanicity and diabetic medication use. We estimated participant-specific exposures to PM2.5 on a six-kilometer grid covering the conterminous U.S. using spatio-temporal models, and to NO2 using nearest measurements from the Environmental Protection Agency's Air Quality System. HbA1c levels were measured for participants in each of two data collection waves from dried blood spots and log-transformed prior to analysis. Participants were considered diabetic if they had HbA1c values≥6.5% or reported taking diabetic medication.ResultsThe prevalence of diabetes at study entry was 22.2% (n=916) and the mean HbA1c was 6.0±1.1%. Mean one-year moving average PM2.5 and NO2 exposures were 10.4±3.0μg/m3 and 13.1±7.0 ppb, respectively. An inter-quartile range (IQR, 3.9μg/m3) increase in one-year moving average PM2.5 was positively associated with increased diabetes prevalence (prevalence odds ratio, POR 1.35, 95% CI: 1.19, 1.53). Similarly, an IQR (8.6 ppb) increase in NO2 was also significantly associated with diabetes prevalence (POR 1.27, 95% CI: 1.10, 1.48). PM2.5 (1.8%±0.6%, p<0.01) and NO2 (2.0%±0.7%, p<0.01) exposures were associated with higher HbA1c levels in diabetic participants, while only NO2 was significantly associated with HbA1c in non-diabetic participants (0.8%±0.2%, p<0.01). Significant dose response relationships were identified for both pollutants in diabetic participants and for NO2 in non-diabetic participants.Conclusions/interpretationsIn a cohort of older men and women in the United States, PM2.5 and NO2 exposures were significantly associated with prevalence of DM and increased HbA1c levels among both non-diabetic and diabetic participants. These associations suggest that air pollution could be a key risk factor for abnormal glucose metabolism and diabetes in the elderly.

Dataset Information

Smartphones and Apps to Control Glycosylated Hemoglobin (HbA1c) Level in Diabetes: A Systematic Review and Meta-Analysis.

Publications

Smartphones and Apps to Control Glycosylated Hemoglobin (HbA1c) Level in Diabetes: A Systematic Review and Meta-Analysis.

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