@文章{信息:doi/10.2196/23244，作者=“Eberle, Claudia和Stichling, Stefanie”，标题=“远程医疗干预管理1型和2型糖尿病的临床改善:系统元评价”，期刊=“J医学互联网研究”，年=“2021”，月=“2月”，日=“19”，卷=“23”，数=“2”，页=“e23244”，关键词=“1型糖尿病;2型糖尿病;电子健康;远程医疗;疾病管理;系统评价;背景:糖尿病(DM)是世界上最大的健康威胁之一，发病率不断上升。全球数字化为糖尿病管理带来了新的数字化方法，例如远程医疗干预。远程医疗是信息和通信技术的使用，可以跨越空间距离提供医疗服务，通过增加获得糖尿病护理和医疗信息的机会来改善临床患者的结果。目的:本研究旨在通过合并1型糖尿病(T1DM)和2型糖尿病(T2DM)患者的研究，检验远程医疗干预是否有效改善糖尿病控制，以及诊断为T2DM的患者是否比诊断为T1DM的患者受益更大。 We analyzed the primary outcome glycated hemoglobin A1c (HbA1c) and the secondary outcomes fasting blood glucose (FBG), blood pressure (BP), body weight, BMI, quality of life (QoL), cost, and time saving. Methods: Publications were systematically identified by searching Cochrane Library, MEDLINE via PubMed, Web of Science Core Collection, Embase, and CINAHL databases for studies published between January 2008 and April 2020, considering systematic reviews (SRs), meta-analyses (MAs), randomized controlled trials (RCTs), and clinical trials (CTs). Study quality was assessed using the A Measurement Tool to Assess Systematic Reviews, Effective Public Health Practice Project, and National Institute for Health and Care Excellence qualitative checklist. We organized the trials by communication technologies in real-time video or audio interventions, asynchronous interventions, and combined interventions (synchronous and asynchronous communication). Results: From 1116 unique citations, we identified 31 eligible studies (n=15 high, n=14 moderate, n=1 weak, and n=1 critically low quality). We selected 21 SRs and MAs, 8 RCTs, 1 non-RCT, and 1 qualitative study. Of the 10 trials, 3 were categorized as real-time video, 1 as real-time video and audio, 4 as asynchronous, and 2 as combined intervention. Significant decline in HbA1c levels based on pooled T1DM and T2DM patients data ranged from −0.22{\%} weighted mean difference (WMD; 95{\%} CI −0.28 to −0.15; P<.001) to −0.64{\%} mean difference (95{\%} CI −1.01 to −0.26; P<.001). The intervention effect on lowering HbA1c values might be significantly smaller for patients with T1DM than for patients with T2DM. Evidence on the impact on BP, body weight, FBG, cost effectiveness, and time saving was smaller compared with HbA1c but indicated potential in some publications. Conclusions: Telemedical interventions might be clinically effective in improving diabetes control overall, and they might significantly improve HbA1c concentrations. Patients with T2DM could benefit more than patients with T1DM regarding lowering HbA1c levels. Further studies with longer duration and larger cohorts are necessary. ", issn="1438-8871", doi="10.2196/23244", url="//www.mybigtv.com/2021/2/e23244/", url="https://doi.org/10.2196/23244", url="http://www.ncbi.nlm.nih.gov/pubmed/33605889" }