Background: Type 2 diabetes mellitus (T2DM) is a chronic metabolic condition that is associated with multiple comorbidities. Apart from pharmacological approaches, patient self-management remains the gold standard of care for diabetes. Improving patients' self-management among the elderly with mobile health (mHealth) interventions is critical, especially in times of the COVID-19 pandemic. However, the extent of mHealth efficacy in managing T2DM in the older population remains unknown. Hence, the present review examined the effectiveness of mHealth interventions on cardiometabolic outcomes in older adults with T2DM.
Methods: A systematic search from the inception till May 31, 2021, in the MEDLINE, Embase, and PubMed databases was conducted, and 16 randomized controlled trials were included in the analysis.
Results: The results showed significant benefits on glycosylated hemoglobin (HbA1c) (mean difference -0.24%; 95% confidence interval [CI]: -0.44, -0.05; p = 0.01), postprandial blood glucose (-2.91 mmol/L; 95% CI: -4.78, -1.03; p = 0.002), and triglycerides (-0.09 mmol/L; 95% CI: -0.17, -0.02; p = 0.010), but not on low-density lipoprotein cholesterol (-0.06 mmol/L; 95% CI: -0.14, 0.02; p = 0.170), high-density lipoprotein cholesterol (0.05 mmol/L; 95% CI: -0.03, 0.13; p = 0.220), and blood pressure (systolic blood pressure -0.82 mm Hg; 95% CI: -4.65, 3.00; p = 0.670; diastolic blood pressure -1.71 mmHg; 95% CI: -3.71, 0.29; p = 0.090).
Conclusions: Among older adults with T2DM, mHealth interventions were associated with improved cardiometabolic outcomes versus usual care. Its efficacy can be improved in the future as the current stage of mHealth development is at its infancy. Addressing barriers such as technological frustrations may help strategize approaches to further increase the uptake and efficacy of mHealth interventions among older adults with T2DM.
概述: 2型糖尿病(T2DM)是一种与多种疾病相关的慢性代谢疾病。除药物治疗外, 患者自我管理仍然是糖尿病治疗的金标准。在COVID-19大流行期间, 通过移动医疗(mHealth)干预措施改善老年人的自我管理至关重要。然而, 移动医疗在老年人群中治疗2型糖尿病的疗效仍不清楚。因此, 本综述研究了移动健康干预对老年2型糖尿病患者心脏代谢结局的有效性。 方法: 从研究开始到2021年5月31日, 对MEDLINE、Embase和PubMed数据库进行了系统检索, 并将16项随机对照试验纳入分析。 结果: HbA1c (平均差-0.24%;95% ci: -0.44, -0.05;p=0.01)、餐后血糖(-2.91 mmol/L;95%ci:-4.78, -1.03;p=0.002)和甘油三酯(-0.09mmol/L;95%ci:-0.17, -0.02;p=0.010)明显改善, 而低密度脂蛋白胆固醇(-0.06 mmol/L;95% ci: -0.14, 0.02;p=0.170)、高密度脂蛋白胆固醇(0.05 mmol/L;95% ci: -0.03, 0.13;p=0.220)和血压(SBP -0.82 mmHg;95% ci: -4.65, 3.00;p = 0.670;DBP: -1.71 mmHg;95% ci: -3.71, 0.29;p = 0.090)并无获益。 结论: 在患有2型糖尿病的老年人中, 与常规护理相比, 移动健康干预与改善心脏代谢结果相关。由于当前阶段的移动医疗发展尚处于起步阶段, 其疗效在未来可以得到改进。解决技术等障碍可能有助于策略的制定, 进一步提高患有2型糖尿病的老年人对移动健康干预措施的接受度和有效性。.
Keywords: 2型糖尿病; digital health intervention; older adults; type 2 diabetes mellitus; 数字健康干预; 老年人.
© 2023 The Authors. Journal of Diabetes published by Ruijin Hospital, Shanghai JiaoTong University School of Medicine and John Wiley & Sons Australia, Ltd.