Effects of mobile phone management applications for biological and biochemical parameters in patients with type 2 diabetes mellitus: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

DENG Nan ¹ , HE Hong ² , WANG Ya ¹ ,  ZHANG Xiaoyi ³

1. Affiliated Hospital of Nantong University, Nantong, 226001, P.R.China;
2. Department of Nursing, Affiliated Hospital of Nantong University, Nantong, 226001, P.R.China;
3. Department of Endocrinology, Affiliated Hospital of Nantong University, Nantong, 226001, P.R.China;

Corresponding author：

ZHANG Xiaoyi, Email: 756385625@qq.com

Keywords：

Diabetes; Self-management; Mobile phone applications; Meta-analysis; Randomized controlled trial; Systematic review

DOI：

10.7507/1672-2531.201704096

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Objective To systematically review the effect of mobile phone management applications (APP) on biological and biochemical parameters in adults with type 2 diabetes mellitus (T2DM). Methods We electronically searched databases including PubMed, EMbase, The Cochrane Library, Web of Science, CINAHL, PsycINFO, WanFang Data, CBM, CNKI for randomized controlled trials compared mobile phone APP as interventions for managing T2DM with traditional methods from inception to September 30^th 2016. Two researchers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was conducted using Stata 12.0 software. Results A total of 10 studies including 1 030 participants (563 in the App group and 467 in the traditional group) were included. The results of meta-analysis showed that the mobile phone app-based interventions group were superior to the control group in HbA1c (MD=–0.43, 95% CI –0.65 to –0.22, P<0.001), systolic blood pressure (MD=–2.53, 95% CI –4.89 to –0.17,P<0.05), triglyceride (SMD=–0.24, 95% CI –0.42 to –0.06,P<0.05) and waist circumference (MD=–1.57, 95% CI –2.65 to –0.48,P<0.05). No significant different were found on any other related results between two groups. Conclusion Mobile phone apps aimed at diabetes management can improve HbA1c, systolic blood pressure, triglyceride, and waist circumference for patients with T2DM. Due to the limited quality and quantity of the included studies, the above conclusions are needed more high quality studies to verify.

Citation： DENG Nan, HE Hong, WANG Ya, ZHANG Xiaoyi. Effects of mobile phone management applications for biological and biochemical parameters in patients with type 2 diabetes mellitus: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2017, 17(10): 1167-1173. doi: 10.7507/1672-2531.201704096 Copy

1.	Litwak L, Goh SY, Hussein Z, et al. Prevalence of diabetes complications in people with type 2 diabetes mellitus and its association with baseline characteristics in the multinational A1chieve study. Diabetol Metab Syndr, 2013, 5(1): 57.
2.	Tuomi T, Santoro N, Caprio S, et al. The many faces of diabetes: a disease with increasing heterogeneity. Lancet, 2014, 383(9922): 1084-1094.
3.	Htoo ZW, Hsu WW, Rosenkranz R. Systematic review and meta-analysis: is lifestyle modification effective for glycemic control among adults with type II diabetes in Southeast Asia? Diabetes Res Clin Pract, 2016, 122: 148-153.
4.	Alsairafi ZK, Taylor KM, Smith FJ, et al. Patients' management of type 2 diabetes in Middle Eastern countries: review of studies. Patient Prefer Adherence, 2016, 10: 1051-1062.
5.	Aitken M, Lyle J. Patient adoption of mHealth: use, evidence and remaining barriers to mainstream acceptance. Parsippany. New York: IMS Institute for Healthcare Informatics, 2015.
6.	Brzan PP, Rotman E, Pajnkihar M, et al. Mobile applications for control and self management of diabetes: a systematic review. J Med Syst, 2016, 40(9): 210.
7.	Quinn CC, Clough SS, Minor JM, et al. WellDoc mobile diabetes management randomized controlled trial: change in clinical and behavioral outcomes and patient and physician satisfaction. Diabetes Technol Ther, 2008, 10(3): 160-168.
8.	Karhula T, Vuorinen AL, Raapysjarvi K, et al. Telemonitoring and mobile phone-based health coaching among Finnish diabetic and heart disease patients: randomized controlled trial. J Med Internet Res, 2015, 17(6): 153.
9.	Quinn CC, Shardell MD, Terrin ML, et al. Cluster-randomized trial of a mobile phone personalized behavioral intervention for blood glucose control. Diabetes Care, 2011, 34(9): 1934-1942.
10.	Orsama AL, Harno K, Kulju M, et al. Active assistance technology reduces glycosylated hemoglobin and weight in individuals with type 2 diabetes: results of a theory-based randomized trial. Diabetes Technol Ther, 2013, 15(8): 662-669.
11.	Holtz B, Lauckner C. Diabetes management via mobile phones: a systematic review. Telemedi J E Health, 2012, 18(3): 175.
12.	Liang X, Wang Q, Yang X, et al. Effect of mobile phone intervention for diabetes on glycaemic control: a meta-analysis. Diabet Med, 2011, 28(4): 455-463.
13.	Krishna S, Boren SA. Diabetes self-management care via cell phone: a systematic review. J Diabetes Sci Technol, 2008, 2(3): 509-517.
14.	Wu Y, Yao X, Vespasiani G, et al. Mobile app-based interventions to support diabetes self-management: a systematic review of randomized controlled trials to identify functions associated with glycemic efficacy. JMIR Mhealth Uhealth, 2017, 5(3): e35.
15.	Hou C, Carter B, Hewitt J, et al. Do mobile phone applications improve glycemic control (HbA1c) in the self-management of diabetes? A systematic review, meta-analysis, and grade of 14 randomized trials. Diabetes Care, 2016, 39(11): 2089.
16.	Cui M, Wu X, Mao J, et al. T2DM self-management via smart phone applications: a systematic review and meta-analysis. PLoS One, 2016, 11(11): e0166718.
17.	Patsopoulos NA, Evangelou E, Ioannidis JP. Sensitivity of between-study heterogeneity in meta-analysis: proposed metrics and empirical evaluation. Int J Epidemiol, 2008, 37(5): 1148-1157.
18.	Egger M, Davey SG, Schneider M, et al. Bias in meta-analysis detected by a simple, graphical test. BMJ, 1997, 315(7109): 629-634.
19.	Sutton AJ, Duval SJ, Tweedie RL, et al. Empirical assessment of effect of publication bias on meta-analyses. BMJ, 2000, 320(7249): 1574-1577.
20.	Faridi Z, Liberti L, Shuval K, et al. Evaluating the impact of mobile telephone technology on type 2 diabetic patients' self-management: the NICHE pilot study. J Eval Clin Pract, 2008, 14(3): 465-469.
21.	Waki K, Fujita H, Uchimura Y, et al. DialBetics: a novel smart phone-based self-management support system for type 2 diabetes patients. J Diabetes Sci Technol, 2014, 8(2): 209-215.
22.	Yoo HJ, Park MS, Kim TN, et al. A ubiquitous chronic disease care system using cellular phones and the internet. Diabet Med, 2009, 26(6): 628-635.
23.	Holmen H, Torbjørnsen A, Wahl AK, et al. A mobile health intervention for self-management and lifestyle change for persons with type 2 diabetes, part 2: one-year results from the norwegian randomized controlled trial renewing health. JMIR Mhealth Uhealth, 2014, 2(4): e57.
24.	Rodríguez-Idígoras MI, Sepúlveda-Muñoz J, Sánchez-Garrido-Escudero R, et al. Telemedicine influence on the follow-up of type 2 diabetes patients. Diabetes Technol Ther, 2009, 11(7): 431-437.
25.	戴霞, 麻晓君, 陆丽荣, 等. " 糖卫士”APP 应用于糖尿病延续护理的实践. 中国护理管理, 2016, 16(7): 963-967.0.
26.	Smith KJ, Rabasa-Lhoret R, Strychar I, et al. Good vs. Poor self-rated diabetes control: differences in cardiovascular risk and self-care activities. Exp Clin Endocrinol Diabetes, 2014, 122(4): 236-239.
27.	Noor S, Khan RU, Ahmad J. Understanding diabetic foot infection and its management. Diabetes Metab Syndr, 2017, 11(2): 149-156.
28.	Mowatt L. Diabetic retinopathy and its risk factors at the university hospital in Jamaica. Middle East Afr J Ophthalmol, 2013, 20(4): 321-326.
29.	Boer IHD, Group FE. Kidney disease and related findings in the diabetes control and complications trial/epidemiology of diabetes interventions and complications study. Diabetes Care, 2014, 37(1): 24-30.
30.	Pal K, Eastwood SV, Michie S, et al. Computer-based diabetes self-management interventions for adults with type 2 diabetes mellitus. Cochrane Database Syst Rev, 2013, (3): CD008776.
31.	Sircar M, Bhatia A, Munshi M. Review of hypoglycemia in the older adult: clinical implications and management. Can J Diabetes, 2016, 40(1): 66-72.
32.	Meunier S, Coulombe S, Beaulieu MD, et al. Longitudinal testing of the information-motivation-behavioral skills model of self-care among adults with type 2 diabetes. Patient Educ Couns, 2016, 99(11): 1830-1836.
33.	Davis SA, Carpenter D, Cummings DM, et al. Patient adoption of an internet based diabetes medication tool to improve adherence: a pilot study. Patient Educ Couns, 2017, 100(1): 174-178.

1. Litwak L, Goh SY, Hussein Z, et al. Prevalence of diabetes complications in people with type 2 diabetes mellitus and its association with baseline characteristics in the multinational A1chieve study. Diabetol Metab Syndr, 2013, 5(1): 57.
2. Tuomi T, Santoro N, Caprio S, et al. The many faces of diabetes: a disease with increasing heterogeneity. Lancet, 2014, 383(9922): 1084-1094.
3. Htoo ZW, Hsu WW, Rosenkranz R. Systematic review and meta-analysis: is lifestyle modification effective for glycemic control among adults with type II diabetes in Southeast Asia? Diabetes Res Clin Pract, 2016, 122: 148-153.
4. Alsairafi ZK, Taylor KM, Smith FJ, et al. Patients' management of type 2 diabetes in Middle Eastern countries: review of studies. Patient Prefer Adherence, 2016, 10: 1051-1062.
5. Aitken M, Lyle J. Patient adoption of mHealth: use, evidence and remaining barriers to mainstream acceptance. Parsippany. New York: IMS Institute for Healthcare Informatics, 2015.
6. Brzan PP, Rotman E, Pajnkihar M, et al. Mobile applications for control and self management of diabetes: a systematic review. J Med Syst, 2016, 40(9): 210.
7. Quinn CC, Clough SS, Minor JM, et al. WellDoc mobile diabetes management randomized controlled trial: change in clinical and behavioral outcomes and patient and physician satisfaction. Diabetes Technol Ther, 2008, 10(3): 160-168.
8. Karhula T, Vuorinen AL, Raapysjarvi K, et al. Telemonitoring and mobile phone-based health coaching among Finnish diabetic and heart disease patients: randomized controlled trial. J Med Internet Res, 2015, 17(6): 153.
9. Quinn CC, Shardell MD, Terrin ML, et al. Cluster-randomized trial of a mobile phone personalized behavioral intervention for blood glucose control. Diabetes Care, 2011, 34(9): 1934-1942.
10. Orsama AL, Harno K, Kulju M, et al. Active assistance technology reduces glycosylated hemoglobin and weight in individuals with type 2 diabetes: results of a theory-based randomized trial. Diabetes Technol Ther, 2013, 15(8): 662-669.
11. Holtz B, Lauckner C. Diabetes management via mobile phones: a systematic review. Telemedi J E Health, 2012, 18(3): 175.
12. Liang X, Wang Q, Yang X, et al. Effect of mobile phone intervention for diabetes on glycaemic control: a meta-analysis. Diabet Med, 2011, 28(4): 455-463.
13. Krishna S, Boren SA. Diabetes self-management care via cell phone: a systematic review. J Diabetes Sci Technol, 2008, 2(3): 509-517.
14. Wu Y, Yao X, Vespasiani G, et al. Mobile app-based interventions to support diabetes self-management: a systematic review of randomized controlled trials to identify functions associated with glycemic efficacy. JMIR Mhealth Uhealth, 2017, 5(3): e35.
15. Hou C, Carter B, Hewitt J, et al. Do mobile phone applications improve glycemic control (HbA1c) in the self-management of diabetes? A systematic review, meta-analysis, and grade of 14 randomized trials. Diabetes Care, 2016, 39(11): 2089.
16. Cui M, Wu X, Mao J, et al. T2DM self-management via smart phone applications: a systematic review and meta-analysis. PLoS One, 2016, 11(11): e0166718.
17. Patsopoulos NA, Evangelou E, Ioannidis JP. Sensitivity of between-study heterogeneity in meta-analysis: proposed metrics and empirical evaluation. Int J Epidemiol, 2008, 37(5): 1148-1157.
18. Egger M, Davey SG, Schneider M, et al. Bias in meta-analysis detected by a simple, graphical test. BMJ, 1997, 315(7109): 629-634.
19. Sutton AJ, Duval SJ, Tweedie RL, et al. Empirical assessment of effect of publication bias on meta-analyses. BMJ, 2000, 320(7249): 1574-1577.
20. Faridi Z, Liberti L, Shuval K, et al. Evaluating the impact of mobile telephone technology on type 2 diabetic patients' self-management: the NICHE pilot study. J Eval Clin Pract, 2008, 14(3): 465-469.
21. Waki K, Fujita H, Uchimura Y, et al. DialBetics: a novel smart phone-based self-management support system for type 2 diabetes patients. J Diabetes Sci Technol, 2014, 8(2): 209-215.
22. Yoo HJ, Park MS, Kim TN, et al. A ubiquitous chronic disease care system using cellular phones and the internet. Diabet Med, 2009, 26(6): 628-635.
23. Holmen H, Torbjørnsen A, Wahl AK, et al. A mobile health intervention for self-management and lifestyle change for persons with type 2 diabetes, part 2: one-year results from the norwegian randomized controlled trial renewing health. JMIR Mhealth Uhealth, 2014, 2(4): e57.
24. Rodríguez-Idígoras MI, Sepúlveda-Muñoz J, Sánchez-Garrido-Escudero R, et al. Telemedicine influence on the follow-up of type 2 diabetes patients. Diabetes Technol Ther, 2009, 11(7): 431-437.
25. 戴霞, 麻晓君, 陆丽荣, 等. " 糖卫士”APP 应用于糖尿病延续护理的实践. 中国护理管理, 2016, 16(7): 963-967.0.
26. Smith KJ, Rabasa-Lhoret R, Strychar I, et al. Good vs. Poor self-rated diabetes control: differences in cardiovascular risk and self-care activities. Exp Clin Endocrinol Diabetes, 2014, 122(4): 236-239.
27. Noor S, Khan RU, Ahmad J. Understanding diabetic foot infection and its management. Diabetes Metab Syndr, 2017, 11(2): 149-156.
28. Mowatt L. Diabetic retinopathy and its risk factors at the university hospital in Jamaica. Middle East Afr J Ophthalmol, 2013, 20(4): 321-326.
29. Boer IHD, Group FE. Kidney disease and related findings in the diabetes control and complications trial/epidemiology of diabetes interventions and complications study. Diabetes Care, 2014, 37(1): 24-30.
30. Pal K, Eastwood SV, Michie S, et al. Computer-based diabetes self-management interventions for adults with type 2 diabetes mellitus. Cochrane Database Syst Rev, 2013, (3): CD008776.
31. Sircar M, Bhatia A, Munshi M. Review of hypoglycemia in the older adult: clinical implications and management. Can J Diabetes, 2016, 40(1): 66-72.
32. Meunier S, Coulombe S, Beaulieu MD, et al. Longitudinal testing of the information-motivation-behavioral skills model of self-care among adults with type 2 diabetes. Patient Educ Couns, 2016, 99(11): 1830-1836.
33. Davis SA, Carpenter D, Cummings DM, et al. Patient adoption of an internet based diabetes medication tool to improve adherence: a pilot study. Patient Educ Couns, 2017, 100(1): 174-178.

Chinese Journal of Evidence-Based Medicine

Effects of mobile phone management applications for biological and biochemical parameters in patients with type 2 diabetes mellitus: a meta-analysis

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