Advanced information technologies in management of type 2 diabetes mellitus: A network meta-analysis (Preprint)

2021 ◽  
Author(s):  
Jia Zhang ◽  
Xi Liu ◽  
Liling Wei ◽  
Qiong Zeng ◽  
Kun Lin

BACKGROUND Type 2 diabetes mellitus(T2DM)is one of the most common chronic disease worldwide, and the number of people with T2DM is expected to exceed 9% of the world’s population by 2035, which puts heavy pressure on patients and the health-care system. Recently, self-management of the diabetes had been making great progress with the development of the advance technology. There were many new self-management interventions, including computer-based deliver, telephone deliver and so on. OBJECTIVE The network meta‐analysis was designed to comprehensively evaluate the efficacy of self-management for T2DM in present study. METHODS Keywords “Type 2 diabetes mellitus” and “self-management intervention” were used as searching strategies through PubMed, Cochrane library, MEDLINE, and EMBASE databases (inception–May2, 2020). The search criteria were RCT studies and reported in English language. The primary outcome was the change in HbA1c from baseline. We perform the pairwise meta-analysis and Bayesian NMA to investigate the efficacy of self-management in patients with T2DM, applying Revman 5.3, Stata 14.0 software and GeMTC 0.14.3. RESULTS Thirty-five studies met the inclusion criteria and qualified for the ultimate meta-analysis. Our meta-analysis displayed three advance self-management for T2DM, including computer-based deliver, telephone deliver and telemonitoring deliver. All of these self-management measures had been proven to be more effective than placebo in blood glucose management, and computer-based deliver is most likely to become the most efficient way among them. CONCLUSIONS Compared with other self-management, the computer-based deliver was the most effective self-management for T2DM.

Author(s):  
Kingshuk Pal ◽  
Sophie V Eastwood ◽  
Susan Michie ◽  
Andrew J Farmer ◽  
Maria L Barnard ◽  
...  

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e020062 ◽  
Author(s):  
Xiaosu Bai ◽  
Zhiming Liu ◽  
Zhisen Li ◽  
Dewen Yan

ObjectivesSeveral patients with type 2 diabetes mellitus (T2DM) have depressive disorders. Whether insulin treatment was associated with increased risk of depression remains controversial. We performed a meta-analysis to evaluate the association of insulin therapy and depression.DesignA meta-analysis.MethodsWe conducted a systematic search of PubMed, PsycINFO, Embase and the Cochrane Library from their inception to April 2016. Epidemiological studies comparing the prevalence of depression between insulin users and non-insulin users were included. A random-effects model was used for meta-analysis. The adjusted and crude data were analysed.ResultsTwenty-eight studies were included. Of these, 12 studies presented with adjusted ORs. Insulin therapy was significantly associated with increased risk of depression (OR=1.41, 95% CI 1.13 to 1.76, p=0.003). Twenty-four studies provided crude data. Insulin therapy was also associated with an odds for developing depression (OR=1.59, 95% CI 1.41 to 1.80, p<0.001). When comparing insulin therapy with oral antidiabetic drugs, significant association was observed for adjusted (OR=1.42, 95% CI 1.08 to 1.86, p=0.008) and crude (OR=1.61, 95% CI 1.35 to 1.93, p<0.001) data.ConclusionsOur meta-analysis confirmed that patients on insulin therapy were significantly associated with the risk of depressive symptoms.


2021 ◽  
Author(s):  
xin wei ◽  
yu bai ◽  
zhuo wang ◽  
xiaohong zheng ◽  
zening jin ◽  
...  

Abstract Background: Dipeptidyl peptidase-4 inhibitors (DPP-4i) provide a unique anti-hyperglycemic effect through regulating incretin peptides in type 2 diabetes mellitus (T2DM) patients that are inadequately controlled with insulin therapy. The aim of this study was to investigate the impact of DPP-4i on leptin concentrations in subjects with T2DM. Methods: Randomized controlled trials (RCTs) with comparators were identified through systematically searching PubMed, Embase, and Cochrane library. Quantitative analysis was performed with a fixed or random-effects model according to heterogeneity. Publication bias was evaluated by using the standard methods for sensitivity analysis. Results: Ten trials with 698 patients with T2DM were included. Pooled analysis demonstrated that DPP-4i did not significantly change leptin concentrations (1.31 ng/mL, 95% CI, -0.48 to 3.10). DPP-4i exerted no stronger effect on modulating leptin levels compared to active comparators (0.21 ng/mL, 95% CI, -1.37 to 1.78). Meta-analysis was powerful and stable after sensitivity analysis.Conclusions: DDP-4i did not modulate leptin concentrations and exerted no stronger effect than traditional antidiabetic agents.


2020 ◽  
Vol 26 (6) ◽  
pp. 431
Author(s):  
Hassan Hosseinzadeh ◽  
Iksheta Verma ◽  
Vinod Gopaldasani

Patient activation has been recognised as a reliable driver of self-management decision-making. This systematic review and meta-analysis examines existing evidence on whether embedding patient activation within Type 2 diabetes mellitus (T2DM) self-management programs can improve patient outcomes. This review has included 10 randomised controlled trials (RCTs) conducted between 2004 and 2019 retrieved from well-known databases such as MEDLINE, PubMed, CINAHL Plus, Scopus, ProQuest and ScienceDirect. The eligible RCTs were excluded if they scored low according to Cochrane Collaboration’s ‘risk of bias’ criteria. Random-effects meta-analyses showed that there were no significance changes in haemoglobin A1C (HbA1c), body mass index (BMI) and patient activation measure (PAM) between intervention and control groups after the intervention; however, the systematic review findings indicated that an improved patient activation level led to significant improvements in T2DM self-management and clinical outcomes including HbA1c level. Studies with a longer follow-up period conducted in community settings and delivered by peer coaches were more likely to lead to significant improvement in both patient activation levels and T2DM self-management and clinical outcomes. This review concludes that patient activation can be used as a reliable tool for improving T2DM self-management and clinical outcomes.


2020 ◽  
Vol 26 (44) ◽  
pp. 5732-5738
Author(s):  
Qian Wu ◽  
Yi-Lin Dan ◽  
Yi-Sheng He ◽  
Kun Xiang ◽  
Yu-Qian Hu ◽  
...  

Background: Meteorin-like (Metrnl) is a newly identified adipokine implicated in the pathogenesis of type 2 diabetes mellitus (T2DM), yet data on the circulating levels of Metrnl in patients with T2DM are controversial. To derive a more precise estimation on circulating Metrnl levels in T2DM patients, we conducted this meta-analysis. Methods: The existing studies on the circulating levels of Metrnl in patients with T2DM published up to 16 January 2020 were comprehensively retrieved from PubMed, Web of Science, EMBASE, and The Cochrane library database. Pooled standard mean difference (SMD) with 95% confidence interval (CI) was calculated using random-effects model. Heterogeneity was assessed and quantified by Cochrane’s Q and I2 statistic. All statistical analyses were performed using Stata 12.0 software. Results: Nine studies with 867 T2DM patients and 831 normal glucose tolerance (NGT) controls were included in the final analysis according to the inclusion criteria. No significant difference in circulating Metrnl levels was found between T2DM patients and NGT individuals (pooled SMD = -0.429, 95% CI = -1.077 to 0.219). Compared to controls, circulating Metrnl levels were significantly higher in the subgroups with BMI <25 kg/m2, using plasma sample and patient sample size ≥100, while circulating Metrnl levels were significantly lower in subgroups with age ≤50 years and homeostatic model assessment for insulin resistance (HOMA-IR) ≥4. Conclusions: This meta-analysis indicates no significant change in circulating Metrnl levels in T2DM patients. However, this result may be influenced by age, BMI, sample type, HOMA-IR and patients sample size. Further longitudinal studies are warranted to offer more insights into the relationship between Metrnl and T2DM.


BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e029073 ◽  
Author(s):  
Xianzhe Wang ◽  
Jiabin Liu ◽  
Lijin Huang ◽  
Hai Zeng ◽  
Guoxin He ◽  
...  

IntroductionType 2 diabetes mellitus (T2DM) is a substantial health problem worldwide. Pre-diabetic state is associated with increased risk for the development of diabetes. There are various pharmacological therapies with glucose-lowering activity for diabetes prevention. Of those, most are being compared with placebo instead of active agents. The relative effects and safety of different glucose-lowering drugs still remain uncertain. To address this gap, we will conduct a systematic review and network meta-analysis (NMA) to evaluate comparative efficacy and safety of glucose-lowering agents for T2DM prevention in patients with pre-diabetes.Methods and analysisPubMed, the Cochrane library and Embase will be searched from inception to December 2019 for relevant randomised controlled trials (RCTs) that examined anti-diabetic drugs for diabetes prevention in patients with pre-diabetes. Two reviewers working independently will screen titles, abstracts and full papers. Data extraction will also be completed by two independent authors. The primary outcome will be the incidence of T2DM in patients with pre-diabetes at baseline. Secondary outcomes will include the achievement of normoglycaemia, all-cause mortality, cardiovascular mortality and hypoglycaemic event. Pairwise meta-analysis and NMA will be conducted for each outcome using a frequentist random-effects model. Additionally, subgroup analyses will also be performed. The comparison-adjusted funnel plot will be used to assess publication bias. The overall quality of evidence will be rated with the Grading of Recommendations Assessment, Development and Evaluation framework. Data analysis will be conducted using Stata V.14.0.Ethics and disseminationEthics approval is not required. We plan to submit the results of this study to a peer-review journal.PROSPERO registration numberCRD42019119157.


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