基于网络和手机的信息技术对1型糖尿病儿童和青少年血糖管理影响的系统评价

A systematic review of effect of information technology based on network and mobile phone on blood glucose management in children and adolescents with type 1 diabetes mellitus

[目的]评价网络、手机等现代信息技术对1型糖尿病儿童和青少年血糖管理的影响。[方法]检索Cochrane图书馆、Joanna Briggs Institute Library、PubMed、EMbase、CBMdisc、CNKI、万方等数据库中关于网络、手机对1型糖尿病儿童和青少年血糖管理影响的随机对照试验。采用Cochrane handbook 5.1.0对文献进行质量评价,利用Revman 5.3进行Meta分析。[结果]共纳入14篇随机对照试验,其中英文13篇、中文1篇。网络、手机等信息技术不能帮助1型糖尿病儿童和青少年有效控制血糖[WMD=-0.09,95%CI(-0.21,0.02),P=0.12],其中网络对1型糖尿病儿童和青少年的血糖控制没有影响[WMD=-0.09,95%CI(-0.11,0.29),P=0.35],手机反而会使1型糖尿病儿童和青少年的血糖控制不良[WMD=-0.18,95%CI(-0.32,-0.04),P=0.01];网络、手机等信息技术不能减少胰岛素使用量[WMD=0.06,95%CI(-0.06,0.19),P=0.32]。[结论]网络和手机等不能帮助1型糖尿病儿童和青少年进行有效的自我管理,但鉴于纳入研究的结局指标异质性较大,文献质量不高,样本量较小,因此尚需要更多设计合理、具有客观统一结局指标的大样本、高质量研究,以获得更可靠的证据。

Objective:To evaluate the effect of modern information technology such as network and mobile phone on blood glucose management in children and adolescents with type 1diabetes mellitus.Methods:Randomized controlled trials(RCT)of network and mobile phone effect on blood glucose management in children and adolescents with type 1diabetes mellitus were retrieved among Cochrane Library,Joanna Briggs Institute Library,PubMed,EMbase,CBMdisc,CNKI,Wanfang data and other databases.The quality of the literature was evaluated using Cochrane handbook 5.1.0,and meta-analysis was performed using Revman 5.3.Results:A total of 14 RCTs were included,of which 13 were in English and 1was in Chinese.Network,mobile phone and other information technology cannot help type 1diabetes children and adolescents to control the blood glucose effectively[WMD=-0.09,95%CI(-0.22,0.02),P=0.12],in which the network has no effect on blood glucose control of type 1diabetes children and adolescents[WMD=0.09,95%CI(-0.11,0.29),P=0.35],while the mobile phone could decrease the control of blood glucose in type 1diabetes children and adolescents[WMD=-0.18,95%CI(-0.32,-0.04),P=0.01].The application of modern information technology such as network and mobile phone cannot reduce the use of insulin [WMD=0.06,95%CI(-0.06,0.19),P=0.32].Conclusions:The network and mobile phone did not contribute to the effective self-management of children and adolescents with type 1diabetes mellitus.However,since the heterogeneity of the outcome index was large,the quality of the literature was not good,and the sample size is small,there still need more reasonable design,union objective outcome of a large sample,and high-quality RCTs,in order to obtain a more reliable evidence.