The impact of structured self-monitoring of blood glucose on clinical, behavioral, and psychosocial outcomes among adults with non-insulin-treated type 2 diabetes: a systematic review and meta-analysis.
Front Clin Diabetes Healthc
; 4: 1177030, 2023.
Article
em En
| MEDLINE
| ID: mdl-37153750
ABSTRACT
Background:
Self-monitoring of blood glucose (SMBG) is considered of little clinical benefit for adults with non-insulin-treated type 2 diabetes, but no comprehensive review of a structured approach to SMBG has been published to date.Purpose:
To conduct a systematic review and meta-analysis of the impact of sSMBG on HbA1c, treatment modifications, behavioral and psychosocial outcomes, and; examine the moderating effects of sSMBG protocol characteristics on HbA1c. Data sources Four databases searched (November 2020; updated February 2022). Study selection Inclusion criteria non-randomized and randomized controlled trials (RCTs) and prospective observational studies; reporting effect of sSMBG on stated outcomes; among adults (≥18 years) with non-insulin-treated type 2 diabetes. Studies excluded if involving children or people with insulin-treated or other forms of diabetes. Data extraction andanalysis:
Outcome data extracted, and risk of bias/quality assessed independently by two researchers. Meta-analysis was conducted for RCTs, and moderators explored (HbA1c only). Datasynthesis:
From 2,078 abstracts, k=23 studies were included (N=5,372). Risk of bias was evident and study quality was low. Outcomes assessed included HbA1c (k=23), treatment modification (k=16), psychosocial/behavioral outcomes (k=12). Meta-analysis revealed a significant mean difference favoring sSMBG in HbA1c (-0·29%, 95% CI -0·46 to -0·11, k=13) and diabetes self-efficacy (0.17%, 95% CI 0.01 to 0.33, k=2). Meta-analysis revealed no significant moderating effects by protocol characteristics.Limitations:
Findings limited by heterogeneity in study designs, intervention characteristics, and psychosocial assessments.Conclusion:
A small positive effect of sSMBG on HbA1c and diabetes self-efficacy was observed. Narrative synthesis of sSMBG intervention characteristics may guide future implementation. PROSPERO registration https//www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020208857, identifier CRD42020208857.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Clinical_trials
/
Guideline
/
Observational_studies
/
Prognostic_studies
/
Systematic_reviews
Idioma:
En
Revista:
Front Clin Diabetes Healthc
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Austrália