基于互联网的血糖监测系统对糖尿病病人血糖控制效果的系统评价

Effect of Internet-based blood glucose monitoring system on blood glucose control of diabetic patients:a systematic review

[目的]系统评价基于互联网的血糖监测系统对糖尿病病人血糖控制效果。[方法]计算机检索PubMed、EMbase、Cochrane Library、Web of Science、中国知网、维普、万方等中英文数据库,收集有关应用基于互联网的血糖监测系统对糖尿病病人血糖控制效果的随机对照试验,按照纳入与排除标准进行文献筛选、资料提取和质量评价后,采用RevMan 5.3进行数据分析。[结果]共纳入13项研究,涉及1189例病人。Meta分析结果显示:应用基于互联网的血糖监测系统可以降低糖尿病病人空腹血糖水平[3个月:SMD=-0.28,95%CI(-0.43,-0.12),P=0.0006;9个月:SMD=-0.50,95%CI(-0.94,-0.07),P=0.02;12个月:SMD=-0.51,95%CI(-0.95,-0.08),P=0.02]、糖化血红蛋白水平[3个月:SMD=-0.32,95%CI(-0.45,-0.19),P<0.00001;6个月:SMD=-0.49,95%CI(-0.62,-0.37),P<0.00001;9个月:SMD=-1.05,95%CI(-1.39,-0.71),P<0.00001;12个月:SMD=-1.91,95%CI(-2.44,-1.39),P<0.00001]和餐后2 h血糖水平[3个月:SMD=-0.50,95%CI(-0.67,-0.34),P<0.00001;6个月:SMD=-0.38,95%CI(-0.53,-0.23),P<0.00001;12个月:SMD=-1.04,95%CI(-1.96,-0.11),P=0.03]。[结论]当前证据表明,基于互联网的血糖监测系统对控制血糖水平有积极作用,但其长期效果需要进一步验证,未来仍需高质量、大样本的随机对照试验进一步研究。

Objective:To evaluate the effect of internet-based blood glucose monitoring systems(IBGMS)on blood glucose control in patients with diabetes mellitus.Methods:All randomized controlled trials(RCTs)regarding the effects of IBGMS on blood glucose control in patients with diabetes mellitus were searched in the Cochrane Library and the databases,such as PubMed,MEDLINE,Web of Science,EMbase,VIP,WanFang,CNKI,and so on.According to the inclusion and exclusion criteria literatures were screened.After date extraction and quality evaluation,Meta⁃analysis was conducted by using RevMan 5.3.Results:Thirteen RCTs involving 1189 patients were included.The results of meta-analysis showed that the use of IBGMS could lower the levels of FBG[SMD 3 months=-0.28,95%CI(-0.43,-0.12),P=0.0006;SMD 9 months=-0.50,95%CI(-0.94,-0.07),P=0.02;SMD 12 months=-0.51,95%CI(-0.95,-0.08),P=0.02]、HBA1c[SMD 3 months=-0.32,95%CI(-0.45,-0.19),P<0.00001;SMD 6months=-0.49,95%CI(-0.62,-0.37),P<0.00001;SMD 9 months=-1.05,95%CI(-1.39,-0.71),P<0.00001;SMD 12 months=-1.91,95%CI(-2.44,-1.39),P<0.00001]and 2 hPBG[SMD 3 months=-0.50,95%CI(-0.67,-0.34),P<0.00001;SMD 6 months=-0.38,95%CI(-0.53,-0.23),P<0.00001;SMD 12 months=-1.04,95%CI(-1.96,-0.11),P=0.03].Conclusion:Current evidence shows that IBGMS has positive effects on the control of blood glucose level in diabetic patients.But the long-term effect needs to be verified.In the future,high quality and large sample randomized controlled trials are still needed for further study.