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A Systematic Review of Collective Evidences Investigating the Effect of Diabetes Monitoring Systems and Their Application in Health Care

INTRODUCTION: Diabetes monitoring systems (DMS) are a possible approach for regular control of glucose levels in patients with Type 1 or 2 diabetes in order to improve therapeutic outcomes or to identify and modify inappropriate patient behaviors in a timely manner. Despite the significant number of...

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Autores principales: Kamusheva, Maria, Tachkov, Konstantin, Dimitrova, Maria, Mitkova, Zornitsa, García-Sáez, Gema, Hernando, M. Elena, Goettsch, Wim, Petrova, Guenka
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8008960/
https://www.ncbi.nlm.nih.gov/pubmed/33796074
http://dx.doi.org/10.3389/fendo.2021.636959
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author Kamusheva, Maria
Tachkov, Konstantin
Dimitrova, Maria
Mitkova, Zornitsa
García-Sáez, Gema
Hernando, M. Elena
Goettsch, Wim
Petrova, Guenka
author_facet Kamusheva, Maria
Tachkov, Konstantin
Dimitrova, Maria
Mitkova, Zornitsa
García-Sáez, Gema
Hernando, M. Elena
Goettsch, Wim
Petrova, Guenka
author_sort Kamusheva, Maria
collection PubMed
description INTRODUCTION: Diabetes monitoring systems (DMS) are a possible approach for regular control of glucose levels in patients with Type 1 or 2 diabetes in order to improve therapeutic outcomes or to identify and modify inappropriate patient behaviors in a timely manner. Despite the significant number of studies observing the DMS, no collective evidence is available about the effect of all devices. GOAL: To review and consolidate evidences from multiple systematic reviews on the diabetes monitoring systems and the outcomes achieved. MATERIALS AND METHODS: Internet-based search in PubMed, EMBASE, and Cochrane was performed to identify all studies relevant to the research question. The data regarding type of intervention, type of diabetes mellitus, type of study, change in clinical parameter(s), or another relevant outcome were extracted and summarized. RESULTS: Thirty-three out of 1,495 initially identified studies, involving more than 44,100 patients with Type 1, Type 2, or gestational diabetes for real-time or retrospective Continuous Glucose Monitoring (CGMS), Sensor Augmented Pump Therapy (SAPT), Self-monitoring Blood Glucose (SMBG), Continuous subcutaneous insulin infusion (CSII), Flash Glucose Monitoring (FGM), Closed-loop systems and telemonitoring, were included. Most of the studies observed small nominal effectiveness of DMS. In total 11 systematic reviews and 15 meta-analyses, with most focusing on patients with Type 1 diabetes (10 and 6, respectively), reported a reduction in glycated hemoglobin (HbA1c) levels from 0.17 to 0.70% after use of DMS. CONCLUSION: Current systematic review of already published systematic reviews and meta-analyses suggests that no statistically significant difference exists between the values of HbA1c as a result of application of any type of DMS. The changes in HbA1c values, number and frequency of hypoglycemic episodes, and time in glucose range are the most valuable for assessing the appropriateness and effectiveness of DMS. Future more comprehensive studies assessing the effectiveness, cost-effectiveness, and comparative effectiveness of DMS are needed to stratify them for the most suitable diabetes patients’ subgroups.
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spelling pubmed-80089602021-03-31 A Systematic Review of Collective Evidences Investigating the Effect of Diabetes Monitoring Systems and Their Application in Health Care Kamusheva, Maria Tachkov, Konstantin Dimitrova, Maria Mitkova, Zornitsa García-Sáez, Gema Hernando, M. Elena Goettsch, Wim Petrova, Guenka Front Endocrinol (Lausanne) Endocrinology INTRODUCTION: Diabetes monitoring systems (DMS) are a possible approach for regular control of glucose levels in patients with Type 1 or 2 diabetes in order to improve therapeutic outcomes or to identify and modify inappropriate patient behaviors in a timely manner. Despite the significant number of studies observing the DMS, no collective evidence is available about the effect of all devices. GOAL: To review and consolidate evidences from multiple systematic reviews on the diabetes monitoring systems and the outcomes achieved. MATERIALS AND METHODS: Internet-based search in PubMed, EMBASE, and Cochrane was performed to identify all studies relevant to the research question. The data regarding type of intervention, type of diabetes mellitus, type of study, change in clinical parameter(s), or another relevant outcome were extracted and summarized. RESULTS: Thirty-three out of 1,495 initially identified studies, involving more than 44,100 patients with Type 1, Type 2, or gestational diabetes for real-time or retrospective Continuous Glucose Monitoring (CGMS), Sensor Augmented Pump Therapy (SAPT), Self-monitoring Blood Glucose (SMBG), Continuous subcutaneous insulin infusion (CSII), Flash Glucose Monitoring (FGM), Closed-loop systems and telemonitoring, were included. Most of the studies observed small nominal effectiveness of DMS. In total 11 systematic reviews and 15 meta-analyses, with most focusing on patients with Type 1 diabetes (10 and 6, respectively), reported a reduction in glycated hemoglobin (HbA1c) levels from 0.17 to 0.70% after use of DMS. CONCLUSION: Current systematic review of already published systematic reviews and meta-analyses suggests that no statistically significant difference exists between the values of HbA1c as a result of application of any type of DMS. The changes in HbA1c values, number and frequency of hypoglycemic episodes, and time in glucose range are the most valuable for assessing the appropriateness and effectiveness of DMS. Future more comprehensive studies assessing the effectiveness, cost-effectiveness, and comparative effectiveness of DMS are needed to stratify them for the most suitable diabetes patients’ subgroups. Frontiers Media S.A. 2021-03-16 /pmc/articles/PMC8008960/ /pubmed/33796074 http://dx.doi.org/10.3389/fendo.2021.636959 Text en Copyright © 2021 Kamusheva, Tachkov, Dimitrova, Mitkova, García-Sáez, Hernando, Goettsch and Petrova http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Endocrinology
Kamusheva, Maria
Tachkov, Konstantin
Dimitrova, Maria
Mitkova, Zornitsa
García-Sáez, Gema
Hernando, M. Elena
Goettsch, Wim
Petrova, Guenka
A Systematic Review of Collective Evidences Investigating the Effect of Diabetes Monitoring Systems and Their Application in Health Care
title A Systematic Review of Collective Evidences Investigating the Effect of Diabetes Monitoring Systems and Their Application in Health Care
title_full A Systematic Review of Collective Evidences Investigating the Effect of Diabetes Monitoring Systems and Their Application in Health Care
title_fullStr A Systematic Review of Collective Evidences Investigating the Effect of Diabetes Monitoring Systems and Their Application in Health Care
title_full_unstemmed A Systematic Review of Collective Evidences Investigating the Effect of Diabetes Monitoring Systems and Their Application in Health Care
title_short A Systematic Review of Collective Evidences Investigating the Effect of Diabetes Monitoring Systems and Their Application in Health Care
title_sort systematic review of collective evidences investigating the effect of diabetes monitoring systems and their application in health care
topic Endocrinology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8008960/
https://www.ncbi.nlm.nih.gov/pubmed/33796074
http://dx.doi.org/10.3389/fendo.2021.636959
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