基于互联网的健康管理模式对2型糖尿病病人糖脂代谢水平影响的Meta分析

Effect of internet-based health management model on the level of glucose and lipid metabolism in patients with type 2 diabetes:a Meta-analysis

目的:系统评价基于互联网的健康管理模式对2型糖尿病病人糖脂代谢水平影响的效果。方法:计算机检索中文、英文数据库关于基于互联网的健康管理模式对2型糖尿病病人糖脂代谢影响的随机对照试验。检索时间从各数据建库至2020年12月。按照纳入及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软件进行数据分析。结果:共纳入11篇文献,合计1425例病人,试验组709例,对照组716例。Meta分析结果显示,基于互联网的健康管理模式可以降低随访时间为3个月[SMD=-0.43,95%CI(-0.67,-0.18),P=0.0006]、6个月[SMD=-0.37,95%CI(-0.66,-0.07),P=0.02]、9个月[SMD=-1.30,95%CI(-1.77,-0.83),P<0.00001]、≥12个月[SMD=-1.26,95%CI(-2.04,-0.48),P=0.002]2型糖尿病病人的糖化血红蛋白,降低随访时间为2个月[SMD=-0.72,95%CI(-1.34,-0.10),P=0.02]、9个月[SMD=-0.50,95%CI(-0.94,-0.07),P=0.02]的空腹血糖、餐后2 h血糖[SMD=-0.56,95%CI(-1.03,-0.09),P=0.02]、总胆固醇[SMD=-0.30,95%CI(-0.56,-0.05),P=0.02]、三酰甘油[SMD=-0.14,95%CI(-0.27,-0.02),P=0.02]。结论:现有证据表明,基于互联网的健康管理模式可有效降低2型糖尿病病人糖化血红蛋白、空腹血糖、餐后2 h血糖、总胆固醇和三酰甘油水平,但对糖化血红蛋白短期(≤2个月)、空腹血糖长期效果还不能确定,未来有待临床开展更多大样本、高质量随机对照试验来证实。

Objective:To systematically evaluate the effect of internet-based health management mode on the level of glucose and lipid metabolism in patients with type 2 diabetes.Methods:Randomized controlled trials on the effects of internet-based health management on glycolipid metabolism in patients with type 2 diabetes were retrieved from Chinese and English databases Literature screening,The retrieval time was from the establishment of each datebase to December 2020.Date extraction and quality assessment were carried out according to the inclusion and exclusion criteria,and RevMan 5.3 software was used for data analysis.Results:A total of 11 articles were included,with a total of 1425 patients,709 cases in the experimental group and 716 cases in the control group.Meta-analysis results showed that the internet-based health management model can reduce HbA1c of type 2 diabetic patients whose follow-up time was 3 months[SMD=-0.43,95%CI(-0.67,-0.18),P=0.0006];6 months[SMD=-0.37,95%CI(-0.66,-0.07),P=0.02];9 months[SMD=-1.30,95%CI(-1.77,-0.83),P<0.00001];and≥12 months[SMD=-1.26,95%CI(-2.04,-0.48),P=0.002].The Internet-based health management model can reduce FPG of type 2 diabetes patients whose follow-up time was 2 months[SMD=-0.72,95%CI(-1.34,-0.10),P=0.02]and 9 months[SMD=-0.50,95%CI(-0.94,-0.07),P=0.02].It can also lower 2 hPBG[SMD=-0.56,95%CI(-1.03,-0.09),P=0.02],TC[SMD=-0.30,95%CI(-0.56,-0.05),P=0.02],TG[SMD=-0.14,95%CI(-0.27,-0.02),P=0.02].Conclusion:Existing evidence shows that the internet-based health management model can effectively reduce the levels of HbA1c,FPG,2 hPBG,TC and TG in patients with type 2 diabetes.However,the short-term effects of HbA1c(≤2 months)and long-term effects of FPG are still uncertain,and more large-sample,high-quality randomized controlled trials need to be carried out in the future.