Telemedicine in Improving Glycemic Control Among Children and Adolescents With Type 1 Diabetes Mellitus: Systematic Review and Meta-Analysis

Type 1 diabetes mellitus (T1DM) is the most common chronic autoimmune disease among children and adolescents. Telemedicine has been widely used in the field of chronic disease management and can benefit patients with T1DM. However, existing studies lack high-level evidence related to the effectivene...

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Bibliographic Details
Published in:Journal of medical Internet research 2024-07, Vol.26 (12), p.e51538
Main Authors: Zhang, Kun, Huang, Qiyuan, Wang, Qiaosong, Li, Chengyang, Zheng, Qirong, Li, Zhuoyue, Xu, Dan, Xie, Cuiling, Zhang, Mingqi, Lin, Rongjin
Format: Article
Language:English
Subjects:
Adolescent
Analysis
Blood Glucose
Blood Glucose Self-Monitoring
Blood sugar
Child
Children
Chronic diseases
Cost-Benefit Analysis
Diabetes Mellitus, Type 1 - blood
Diabetes Mellitus, Type 1 - therapy
Diabetic nephropathies
Diabetics
Diseases
Female
Glycated Hemoglobin - analysis
Glycemic Control - methods
Health aspects
Humans
Hypoglycemia - prevention & control
Male
Quality of Life
Randomized Controlled Trials as Topic
Review
Telemedicine
Type 1 diabetes
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Summary:Type 1 diabetes mellitus (T1DM) is the most common chronic autoimmune disease among children and adolescents. Telemedicine has been widely used in the field of chronic disease management and can benefit patients with T1DM. However, existing studies lack high-level evidence related to the effectiveness of telemedicine for glycemic control in children and adolescents with T1DM. This study aims to systematically review the evidence on the effectiveness of telemedicine interventions compared with usual care on glycemic control among children and adolescents with T1DM. In this systematic review and meta-analysis, we searched PubMed, Cochrane Library, Embase, Web of Science (all databases), and CINAHL Complete from database inception to May 2023. We included randomized controlled trials (RCTs) that evaluated the effectiveness of a telemedicine intervention on glycemic control in children and adolescents with T1DM. In total, 2 independent reviewers performed the study selection and data extraction. Study quality was assessed using the Cochrane Risk of Bias 2 tool. Our primary outcome was glycated hemoglobin (HbA ) levels. Secondary outcomes were quality of life, self-monitoring of blood glucose, the incidence of hypoglycemia, and cost-effectiveness. A random-effects model was used for this meta-analysis. Overall, 20 RCTs (1704 participants from 12 countries) were included in the meta-analysis. Only 5% (1/20) of the studies were at high risk of bias. Compared to usual care, telemedicine was found to reduce HbA levels by 0.22 (95% CI -0.33 to -0.10; P
ISSN:1438-8871
1439-4456
1438-8871
DOI:10.2196/51538