scholarly journals Effect of Probiotics Supplementation on Blood Glucose: a Meta-analysis of Randomized Controlled Trials

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Haibo Li ◽  
Qian Zhang ◽  
Yujuan Chen ◽  
Yunfei Zou ◽  
Yu Zhu ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Randomized Trials ◽  
Meta Analysis ◽  
Random Effect ◽  
Randomized Controlled ◽  
Comparison Groups ◽  
Reduce Blood Glucose ◽  
Mean Differences ◽  
Random Effect Models

Purpose: Thisstudy was carried out as a meta-analysis to assess whether probiotics supplementation can reduce blood glucose (BG) levels in Type 2 diabetes mellitus (T2DM) patients. Methods: The analysis included 1005 subjects from 15 probiotics supplementation randomized trials in which changes in BG were reported as one of the end points. Summary estimates of weighted mean differences (WMDs) and 95% confidence intervals (CIs) were obtained by using random-effect models. Meta-regression and sub-group analyses were performed to identify sources of heterogeneity. Results: Probiotics supplementation was associated with significant decreases in BG levels (WMD: -0.29 mmol/L; 95% CI: -0.56, -0.02; P = 0.038), particularly in subjects with T2DM (WMD: -1.11 mmol/L; 95% CI: -1.54, -0.68; P< 0.001), and in trials carried out in Iran (-0.74 mmol/L; 95% CI: -1.30, -0.18; P = 0.009). Baseline BG levels were positively related to magnitude of effect (P< 0.001). Greater bene?cial effects were consistently seen in trials with baseline BG levels ? 7.0 mmol/L (WMD: -0.881 mmol/L; 95% CI: -1.357, -0.405; P < 0.001). However, in the corresponding comparison groups, magnitudes of effect were attenuated and non-signi?cant. Conclusion: These results indicate that probiotics supplementation is effective in reducing the BG levels in subjects with T2DM and in trials with higher baseline BG levels.

scholarly journals SGLT2 inhibitors and the risk of diabetic ketoacidosis among adults with Type 2 Diabetes: A systematic review and meta-analysis

2021 ◽  
Author(s):  
Michael Colacci ◽  
John Fralick ◽  
Ayodele Odutayo ◽  
Michael Fralick
Keyword(s):  
Diabetic Ketoacidosis ◽  
Observational Studies ◽  
Randomized Trials ◽  
Meta Analysis ◽  
Sglt2 Inhibitor ◽  
Sglt2 Inhibitors ◽  
Controlled Trials ◽  
Absolute Rate ◽  
Randomized Controlled

Importance: The risk of diabetic ketoacidosis (DKA) with sodium-glucose cotransporter-2 (SGLT2) inhibitors is unclear. Objective: To examine the risk of DKA with SGLT2 inhibitors in both observational studies and large clinical trials. Data Sources: Searches of PubMed, EMBASE and CENTRAL (inception to 15 April 2019) without language restrictions; conference proceedings; and reference lists. Study Selection: Randomized controlled trials and observational studies that quantified the rate of diabetic ketoacidosis with an SGLT2 inhibitor in comparison to another diabetes medication or placebo. Data Extraction and Synthesis: Two independent investigators abstracted study data and assessed the quality of evidence. Data were pooled using random effects models with the Hartung-Knapp-Sidik-Jonkman method. Main Outcome and Measures: Absolute event rates and hazard ratios for diabetic ketoacidosis were extracted from each study. Results: Seven randomized trials encompassing 42,375 participants and five cohort studies encompassing 318,636 participants were selected. Among the 7 randomized controlled trials, the absolute rate of DKA among patients randomized to an SGLT2 inhibitor ranged from 0.6 to 2.2 events per 1000 person years. Four randomized trials were included in the meta-analysis, and compared to placebo or comparator medication, SGLT2 inhibitors had a 2.4-fold higher risk of DKA (Relative Risk [RR] = 2.46 [95% CI, 1.16-5.21]; I2 = 0%; P = 0.54). Among the 5 observational studies, the absolute rate of DKA associated with SGLT2 inhibitor use ranged from 0.6 to 4.9 per 1000 person years and a 1.7-fold higher rate of DKA compared to another diabetes medication (RR = 1.74 [95% CI, 1.01-2.93]; I2 = 45%; P = 0.12). Conclusions and Relevance: In adults with type 2 diabetes, SGLT2 inhibitors increase the risk of DKA in both observational studies and large randomized clinical trials. Registration: CRD42019146855 Funding Source: None

scholarly journals Effectiveness of Mobile App-Assisted Self-Care Interventions for Improving Patient Outcomes in Type 2 Diabetes and/or Hypertension: Systematic Review and Meta-Analysis of Randomized Controlled Trials (Preprint)

2019 ◽  
Author(s):  
Kaifeng Liu ◽  
Zhenzhen Xie ◽  
Calvin Kalun Or
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Patient Outcomes ◽  
Meta Analysis ◽  
Self Care ◽  
Mobile App ◽  
Randomized Controlled ◽  
Secondary Outcomes

BACKGROUND Mobile app-assisted self-care interventions are emerging promising tools to support self-care of patients with chronic diseases such as type 2 diabetes and hypertension. The effectiveness of such interventions requires further exploration for more supporting evidence. OBJECTIVE A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted to examine the effectiveness of mobile app-assisted self-care interventions developed for type 2 diabetes and/or hypertension in improving patient outcomes. METHODS We followed the Cochrane Collaboration guidelines and searched MEDLINE, Cochrane Library, EMBASE, and CINAHL Plus for relevant studies published between January 2007 and January 2019. Primary outcomes included changes in hemoglobin A<sub>1c</sub> (HbA<sub>1c</sub>) levels, systolic blood pressure (SBP), and diastolic blood pressure (DBP). Changes in other clinical-, behavioral-, knowledge-, and psychosocial-related outcomes were included as secondary outcomes. Primary outcomes and objective secondary outcomes that were reported in at least two trials were meta-analyzed; otherwise, a narrative synthesis was used for data analysis. RESULTS A total of 27 trials were identified and analyzed. For primary outcomes, the use of mobile app-assisted self-care interventions was associated with significant reductions in HbA<sub>1c</sub> levels (standardized mean difference [SMD] −0.44, 95% CI −0.59 to −0.29; <i>P</i>&lt;.001), SBP (SMD −0.17, 95% CI −0.31 to −0.03, <i>P</i>=.02), and DBP (SMD −0.17, 95% CI −0.30 to −0.03, <i>P</i>=.02). Subgroup analyses for primary outcomes showed that several intervention features were supportive of self-management, including blood glucose, blood pressure, and medication monitoring, communication with health care providers, automated feedback, personalized goal setting, reminders, education materials, and data visualization. In addition, 8 objective secondary outcomes were meta-analyzed, which showed that the interventions had significant lowering effects on fasting blood glucose levels and waist circumference. A total of 42 secondary outcomes were narratively synthesized, and mixed results were found. CONCLUSIONS Mobile app-assisted self-care interventions can be effective tools for managing blood glucose and blood pressure, likely because their use facilitates remote management of health issues and data, provision of personalized self-care recommendations, patient–care provider communication, and decision making. More studies are required to further determine which combinations of intervention features are most effective in improving the control of the diseases. Moreover, evidence regarding the effects of these interventions on the behavioral, knowledge, and psychosocial outcomes of patients is still scarce, which warrants further examination.

scholarly journals Effectiveness of Mobile App-Assisted Self-Care Interventions for Improving Patient Outcomes in Type 2 Diabetes and/or Hypertension: Systematic Review and Meta-Analysis of Randomized Controlled Trials

10.2196/15779 ◽  
2020 ◽  
Vol 8 (8) ◽  
pp. e15779 ◽  
Author(s):  
Kaifeng Liu ◽  
Zhenzhen Xie ◽  
Calvin Kalun Or
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Meta Analysis ◽  
Self Care ◽  
Mobile App ◽  
Randomized Controlled ◽  
Secondary Outcomes ◽  
Hba1c Levels

Background Mobile app-assisted self-care interventions are emerging promising tools to support self-care of patients with chronic diseases such as type 2 diabetes and hypertension. The effectiveness of such interventions requires further exploration for more supporting evidence. Objective A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted to examine the effectiveness of mobile app-assisted self-care interventions developed for type 2 diabetes and/or hypertension in improving patient outcomes. Methods We followed the Cochrane Collaboration guidelines and searched MEDLINE, Cochrane Library, EMBASE, and CINAHL Plus for relevant studies published between January 2007 and January 2019. Primary outcomes included changes in hemoglobin A1c (HbA1c) levels, systolic blood pressure (SBP), and diastolic blood pressure (DBP). Changes in other clinical-, behavioral-, knowledge-, and psychosocial-related outcomes were included as secondary outcomes. Primary outcomes and objective secondary outcomes that were reported in at least two trials were meta-analyzed; otherwise, a narrative synthesis was used for data analysis. Results A total of 27 trials were identified and analyzed. For primary outcomes, the use of mobile app-assisted self-care interventions was associated with significant reductions in HbA1c levels (standardized mean difference [SMD] −0.44, 95% CI −0.59 to −0.29; P<.001), SBP (SMD −0.17, 95% CI −0.31 to −0.03, P=.02), and DBP (SMD −0.17, 95% CI −0.30 to −0.03, P=.02). Subgroup analyses for primary outcomes showed that several intervention features were supportive of self-management, including blood glucose, blood pressure, and medication monitoring, communication with health care providers, automated feedback, personalized goal setting, reminders, education materials, and data visualization. In addition, 8 objective secondary outcomes were meta-analyzed, which showed that the interventions had significant lowering effects on fasting blood glucose levels and waist circumference. A total of 42 secondary outcomes were narratively synthesized, and mixed results were found. Conclusions Mobile app-assisted self-care interventions can be effective tools for managing blood glucose and blood pressure, likely because their use facilitates remote management of health issues and data, provision of personalized self-care recommendations, patient–care provider communication, and decision making. More studies are required to further determine which combinations of intervention features are most effective in improving the control of the diseases. Moreover, evidence regarding the effects of these interventions on the behavioral, knowledge, and psychosocial outcomes of patients is still scarce, which warrants further examination.

scholarly journals Correction: Effectiveness of Mobile App-Assisted Self-Care Interventions for Improving Patient Outcomes in Type 2 Diabetes and/or Hypertension: Systematic Review and Meta-Analysis of Randomized Controlled Trials (Preprint)

2020 ◽  
Author(s):  
Kaifeng Liu ◽  
Zhenzhen Xie ◽  
Calvin Kalun Or
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Patient Outcomes ◽  
Meta Analysis ◽  
Self Care ◽  
Mobile App ◽  
Randomized Controlled ◽  
Secondary Outcomes

UNSTRUCTURED Mobile app-assisted self-care interventions are emerging promising tools to support self-care of patients with chronic diseases such as type 2 diabetes and hypertension. The effectiveness of such interventions requires further exploration for more supporting evidence. A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted to examine the effectiveness of mobile app-assisted self-care interventions developed for type 2 diabetes and/or hypertension in improving patient outcomes. We followed the Cochrane Collaboration guidelines and searched MEDLINE, Cochrane Library, EMBASE, and CINAHL Plus for relevant studies published between January 2007 and January 2019. Primary outcomes included changes in hemoglobin A<sub>1c</sub> (HbA<sub>1c</sub>) levels, systolic blood pressure (SBP), and diastolic blood pressure (DBP). Changes in other clinical-, behavioral-, knowledge-, and psychosocial-related outcomes were included as secondary outcomes. Primary outcomes and objective secondary outcomes that were reported in at least two trials were meta-analyzed; otherwise, a narrative synthesis was used for data analysis. A total of 27 trials were identified and analyzed. For primary outcomes, the use of mobile app-assisted self-care interventions was associated with significant reductions in HbA<sub>1c</sub> levels (standardized mean difference [SMD] −0.44, 95% CI −0.59 to −0.29; <i>P</i><.001), SBP (SMD −0.17, 95% CI −0.31 to −0.03, <i>P</i>=.02), and DBP (SMD −0.17, 95% CI −0.30 to −0.03, <i>P</i>=.02). Subgroup analyses for primary outcomes showed that several intervention features were supportive of self-management, including blood glucose, blood pressure, and medication monitoring, communication with health care providers, automated feedback, personalized goal setting, reminders, education materials, and data visualization. In addition, 8 objective secondary outcomes were meta-analyzed, which showed that the interventions had significant lowering effects on fasting blood glucose levels and waist circumference. A total of 42 secondary outcomes were narratively synthesized, and mixed results were found. Mobile app-assisted self-care interventions can be effective tools for managing blood glucose and blood pressure, likely because their use facilitates remote management of health issues and data, provision of personalized self-care recommendations, patient–care provider communication, and decision making. More studies are required to further determine which combinations of intervention features are most effective in improving the control of the diseases. Moreover, evidence regarding the effects of these interventions on the behavioral, knowledge, and psychosocial outcomes of patients is still scarce, which warrants further examination.

scholarly journals Efficacy and Safety of Resveratrol Supplements on Blood Lipid and Blood Glucose Control in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 2021 ◽  
pp. 1-15
Author(s):  
Tianqing Zhang ◽  
Qi He ◽  
Yao Liu ◽  
Zhenrong Chen ◽  
Hengjing Hu
Keyword(s):  
Systematic Review ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Adverse Events ◽  
Meta Analysis ◽  
Blood Lipid ◽  
Controlled Trials ◽  
Randomized Controlled

Background. Diabetes is a major public health concern. Resveratrol has shown great beneficial effects on hyperglycemia and insulin resistance and as an antioxidant. Methods. We searched the Chinese and English databases (such as CNKI, PubMed, and Embase) and extracted data from randomized controlled trials (RCTs). Then, RevMan 5.3 was used for bias risk assessment and meta-analysis. The primary outcome indicators include insulin-resistance-related indicators and blood-lipid-related indicators. This systematic review and meta-analysis was registered in PROSPERO (CRD42018089521). Results. Fifteen RCTs involving 896 patients were included. For insulin-resistance-related indicators, the summary results showed that, compared with the control group, homeostasis model assessment for insulin resistance (HOMA-IR) in the resveratrol group is lower (WMD: −0.99; 95% CI −1.61, −0.38; P = 0.002 ). For blood-lipid-related indicators, the total cholesterol (TC) and triglyceride (TG) in the resveratrol group is of no statistical significance (for TC, WMD: −7.11; 95% CI −16.28, 2.06; P = 0.13 ; for TG, WMD: −2.15; 95% CI −5.52, 1.22; P = 0.21 ). For adverse events, the summary results showed that there was no statistical difference in the incidence of adverse events between the resveratrol and control groups (WMD: 2; 95% CI 0.44, 9.03; P = 0.37 ). Conclusion. Based on the current evidence, resveratrol may improve insulin resistance, lower fasting blood glucose and insulin levels, and improve oxidative stress in patients with type 2 diabetes mellitus.

scholarly journals Association between ApoE polymorphism and type 2 diabetes: A meta-analysis of 59 studies

2019 ◽  
Author(s):  
Dawei Chen ◽  
Jikang Shi ◽  
Yun Li ◽  
Yu Yang ◽  
Hui Yang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Meta Analysis ◽  
Random Effect ◽  
Apoe Polymorphism ◽  
Case Control Studies ◽  
Effective Strategies ◽  
Increased Risk ◽  
Random Effect Models

Abstract(1)AimsDue to the ever increasing incidence of T2DM, it is estimated that only half of the 79 million adults with type 2 diabetes (T2DM) will have adequate access to insulin by 2030 if the current levels of access is not improved. It is urgent to identify the important risk factors for T2DM and develop effective strategies to address the problem of T2DM. Our study aimed to evaluate the association between apolipoprotein E (ApoE) genetic polymorphism and type 2 diabetes, and to provide clues for the etiology of T2DM and even molecular marker of targeted therapy for the treatment of T2DM.(2)MethodsCase-control studies of ApoE polymorphism and T2DM, which were included in PubMed, Web of Science, Medline, WanFang, VIP, and CNKI databases, were selected and evaluated according to criteria of inclusion and exclusion. Eligible data were extracted and pooled, and were analyzed and assessed using R soft-ware (version 3.4.3). Random-effect models were used when heterogeneity existed in between-study, and fixed-effect models were applied otherwise.(3)ResultsA total of 59 studies that consisted of 6,872 cases with T2DM and 8,250 controls were selected. Alleles and genotypes of ApoE between cases and controls were compared. For ApoE alleles, we observed the contrast of ε4 versus ε3 allele yielding a pooled OR of 1.18 (95% CI: 1.09-1.28; P<0.001). For ApoE genotypes, compared with ε3/ε3 genotype, ε2/ε2 genotype showed a possible association with T2DM (OR=1.46; 95% CI: 1.11-1.93; P=0.007), ε3/ε4 genotype had a 1.11-fold risk of developing T2DM (OR=1.11; 95% CI: 1.01-1.22; P=0.039), and ε4/ε4 genotype had a 1.71-fold risk of developing T2DM (OR=1.71; 95% CI: 1.33-2.19; P<0.001).(4)ConclusionsThere is an association between ApoE polymorphism and T2DM: allele ε4 and genotypes (ε2/ε2, ε3/ε4, and ε4/ε4) are associated with the increased risk for the development of T2DM, and they may be risk factors for T2DM.

scholarly journals Effectiveness of Mobile App-Assisted Self-Care Interventions for Improving Patient Outcomes in Type 2 Diabetes and/or Hypertension: Systematic Review and Meta-Analysis of Randomized Controlled Trials (Preprint)

2020 ◽  
Author(s):  
Kaifeng Liu ◽  
Zhenzhen Xie ◽  
Calvin Kalun Or
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Patient Outcomes ◽  
Meta Analysis ◽  
Self Care ◽  
Mobile App ◽  
Randomized Controlled ◽  
Secondary Outcomes

BACKGROUND Mobile app-assisted self-care interventions are emerging promising tools to support self-care of patients with chronic diseases such as type 2 diabetes and hypertension. The effectiveness of such interventions requires further exploration for more supporting evidence. OBJECTIVE A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted to examine the effectiveness of mobile app-assisted self-care interventions developed for type 2 diabetes and/or hypertension in improving patient outcomes. METHODS We followed the Cochrane Collaboration guidelines and searched MEDLINE, Cochrane Library, EMBASE, and CINAHL Plus for relevant studies published between January 2007 and January 2019. Primary outcomes included changes in hemoglobin A<sub>1c</sub> (HbA<sub>1c</sub>) levels, systolic blood pressure (SBP), and diastolic blood pressure (DBP). Changes in other clinical-, behavioral-, knowledge-, and psychosocial-related outcomes were included as secondary outcomes. Primary outcomes and objective secondary outcomes that were reported in at least two trials were meta-analyzed; otherwise, a narrative synthesis was used for data analysis. RESULTS A total of 27 trials were identified and analyzed. For primary outcomes, the use of mobile app-assisted self-care interventions was associated with significant reductions in HbA<sub>1c</sub> levels (standardized mean difference [SMD] −0.44, 95% CI −0.59 to −0.29; <i>P</i><.001), SBP (SMD −0.17, 95% CI −0.31 to −0.03, <i>P</i>=.02), and DBP (SMD −0.17, 95% CI −0.30 to −0.03, <i>P</i>=.02). Subgroup analyses for primary outcomes showed that several intervention features were supportive of self-management, including blood glucose, blood pressure, and medication monitoring, communication with health care providers, automated feedback, personalized goal setting, reminders, education materials, and data visualization. In addition, 8 objective secondary outcomes were meta-analyzed, which showed that the interventions had significant lowering effects on fasting blood glucose levels and waist circumference. A total of 42 secondary outcomes were narratively synthesized, and mixed results were found. CONCLUSIONS Mobile app-assisted self-care interventions can be effective tools for managing blood glucose and blood pressure, likely because their use facilitates remote management of health issues and data, provision of personalized self-care recommendations, patient–care provider communication, and decision making. More studies are required to further determine which combinations of intervention features are most effective in improving the control of the diseases. Moreover, evidence regarding the effects of these interventions on the behavioral, knowledge, and psychosocial outcomes of patients is still scarce, which warrants further examination.

A Randomized controlled trial of SMS Intervention in Inner Mongolia with Type 2 Diabetes (Preprint)

2018 ◽  
Author(s):  
Xue Mei Wang ◽  
Dan Liu ◽  
Mao Lin Du ◽  
Rui Qi Hao ◽  
Hui Qiu Zheng ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Weight Control ◽  
Controlled Trial ◽  
Average Score ◽  
Randomized Controlled ◽  
Sms Intervention ◽  
Better Than

BACKGROUND Nonadherence to self-management is common among patients with type 2 diabetes (T2D) and often leads to severe complications. Short messages service (SMS) technology provides a practical medium for delivering content to address patients’ barriers to adherence. OBJECTIVE The aim of this study was to design a series of SMS intervention templates, and to evaluate the feasibility of the SMS through a short message quality evaluation questionnaire and to explore the intervention effect. METHODS 1. The SMS evaluation was assessed through the 10-point scale SMS Quality Assessment Questionnaire. 2. A randomized controlled trial was conducted. The patients in SMS intervention were randomly divided into intervention group (IG) and control group (CG), which received evaluated messages education and regular education, respectively. The intervention was divided into four phases, a telephone interview was conducted to evaluate the effectiveness of the intervention after each phase. The main outcome were changes in blood glucose and blood pressure (BP) and their control rates, and secondary outcomes were changes in diet, physical activity, weight control and other health-related behaviors. RESULTS 1. SMS design: 42 SMS text messages were designed to promote healthy behaviors in different stages of behavior change, covering four key domains: healthy knowledge, diet, physical activity, living habits and weight control. 2. SMS evaluation: The average score for healthy knowledge, diet, physical activity, living habits, weight control were 8.0 (SD 0.7), 8.5 (SD 0.6), 7.9 (SD 1.0), 8.0 (SD 0.7), and 8.4 (SD 0.9), respectively. 3. SMS intervention: A total of 146 people completed the four-phase intervention, including 72 in the CG and 74 in the IG. At the end of the intervention period, in the IG, the decrease in fasting blood glucose (FBG, mean 1.5mg/l [SD 3.0] vs 0.4 mg/l [SD 2.8], P=0.011), postprandial blood glucose (PBG, mean 5.8mg/l [SD 5.1] vs 4.2 mg/l [SD 4.7], P=0.028), systolic blood pressure (SBP, mean 9.1mmHg [SD 15.8] vs 2.2mmHg [SD 13.3], P=0.025), FBG control rate (45.9% vs 31.0%, P=0.046) and PBG control rate (57.8% vs 33.7%, P=0.002) were better than the CG. In self-behavior management, the changes of the weight control, diet and physical activity in the IG were better than those in the CG, and the average score of the IG was greater than that of the CG (1.1 vs [-0.3] ), P0.001). CONCLUSIONS The overall quality of SMS content is higher to meet the needs of patients; Diet, physical activity and weight control message need to be focused on push. SMS interventions contribute to the management of blood glucose and BP, and help to promote a series of healthy-related behaviors.

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