Meta-Analysis of the Effect of Internet-Based Self- Management on Blood Glucose Control in Type 2 Diabetes Mellitus Patients
AbstractBackground: Diabetes mellitus is a chronic metabolic disorder or disease with numerous etiologies characterized by high blood glucose levels accompanied by lipid, protein, and carbohydrate metabolism disorders. Type 2 diabetes is the most common type of diabetes with about 90% of all diabetes cases. The International Diabetes Federation (IDF) estimates that the number of diabetics in the world can reach 783.7 million people while in Indonesia it is estimated to reach 28.57 million people in 2045. This number is an increase of 46% compared to 536.6 million in 2021. The study aims to discover how much influence internet-based self-management has on blood glucose control in type-2 diabetes mellitus patients.Subjects and Method: It was a meta-analysis study using PRISMA flowchart guidelines with the PICO formulation. P = type 2 diabetes mellitus patients. I = Internet-based self-management. C= No internet-based self-management. O= HbA1C. This study was conducted by searching for articles obtained from the MEDLINE/PubMed, Google Scholar, ProQuest, Science Direct, and Spinger Link databases with keywords and operators “Boolean electronic health record" OR "computerized" OR "healthcare system information" OR "mobile health" OR "mobile app" OR "Telehealth" AND "self-management" AND "Diabetes" OR "diabetes mellitus" OR " type 2 diabetes mellitus" OR "Type 2 diabetes. Based on the database, 10 articles met the inclusion criteria. The analysis was performed using Revman 5.3 software.Results: There were 10 articles from Asia, America, and Europe. A meta-analysis using Randomized Controlled Trials indicated that internet-based self-management significantly reduced HbA1c levels by 0.45 units (SMD= -0.45; CI 95%= -0.57 to -0.33= p<0.001).Conclusion: Internet-based management can reduce HbA1c levels of type 2 diabetes mellitus patients.Keywords: internet-based self-management, hba1c, type 2 diabetes mellitusCorrespondence:Moh Maulana. Masters Program in Public Health, Universitas Sebelas Maret. Jalan Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: email@example.com. Mobile: +628-851 5667 1759Journal of Health Policy and Management (2023)https://doi.org/10.26911/thejhpm.2023.08.02.02
Agboola S, Jethwani K, Lopez L, Searl M, O'Keefe S, Kvedar J (2016). Text To Move: A Randomized Controlled Trial Of A Text-Messaging Program To Improve Physical Activity Behaviors In Patients With Type 2 Diabetes Mellitus. J Med Internet Res. 18(11):1–13.Doi: 10.2196/jmir.6439.
Anzaldo-Campos MC, Contreras S, Vargas-Ojeda A, Menchaca-Dı´az R, Fortmann A, Philis-Tsimikas A. Dulce Wireless Tijuana (2015). A randomized control trial evaluating the impact of project dulce and shortterm mobile technology on glycemic control in a family medicine clinic in Northern Mexico. Diabetes Technol Ther. 18(4):240–51. Doi: 10.1089/dia.2015.0283.
Chan JCN, Sui Y, Oldenburg B, Zhang Y, Chung HHY, Goggins W, Au, S, Brown N, dan et al. (2014). Effects of telephone-based peer support in patients with tipe 2 diabetes mellitus receiving integrated care: a rando-mized clinical trial, JAMA Intern Med. 176(6): 972–81. Doi: 10.1001/jamainternmed.2014.655.
Fortmann AL, Gallo LC, Garcia MI, Taleb M, Euyoque JA, Clark T, Skidmore J, et al. (2017). Dulce Digital: An Health SMS-Based Intervention Improves Glycemic Control in Hispanics With Type 2 Diabetes. Diabetes care, 40-(10), 1349–1355. Doi: 10.2337/dc170230.
Heron KE, Smyth JM (2015). Ecological Momentary Interventions: Incorporating Mobile Technology Into Psychosocial And Health Behaviour Treatments, Br J Health Psychol. 15-(1): 1–39. Doi: 10.1348/135910709X466063.
IDF (2021). Diabetes Is Spiralling Out Of Control, International Diabetes Federation. Available at: https://idf.org/ (Accessed: 10 June 2022).
Kleinman NJ, Shah A, Shah S, Phatak S, Viswanathan V (2017). Improved Medication Adherence and Frequency of Blood Glucose Self-Testing Using an m-Health Platform Versus Usual Care in a Multisite Randomized Clinical Trial Among People with Type 2 Diabetes
in India. Telemedicine journal and e-health : Telemed J E Health. 23(9), 733–740. Doi: 10.1089/tmj.2016.0265.
Lim S, Kang SM, Kim KM, Moon JH, Choi SH, Hwang H, Jung HS, et al. (2016). Multifactorial intervention in diabetes care using realtime monitoring and tailored feedback in type 2 diabetes. Acta diabetol. 53(2), 189–198. Doi: 10.1007/s0059201507548.
Maharani MYY, Hariyati, TS and Sukawana, IW (2018). Mobile health application smart phone based dalam peningkatan self-management pasien diabetes mellitus, J Gema Kep. 11(2): 113-119. Doi: 10.33992/jgk.v11i2.498.
Mohammed S, Islam S, Niessen LW, Ferrari U, Ali L, Seissler J, Lechner A (2015). Effects of Mobile Phone SMS to Improve Glycemic Control Among Patients With Type 2 Diabetes in Bangladesh: A Prospective, Parallel-Group, Randomized Controlled Trial.Diabetes Care. 38(8), e112–e113. Doi: 10.2337/dc150505.
Morrison K, Cohen L, and Manion L. (2014). Research Methods In Education. Sixth Edition. USA and Canada: Routledge Taylor & Francis E-Library.
Nundy S, Dick JJ, Chou CH, Nocon RS, Chin MH dan Peek ME (2014). Mobile Phone Diabetes Project Led To Improved Glycemic Control And Net Savings For Chicago Plan Participants, Healt Aff, 32(2): 265–72. Doi: 10.1377/hlthaff.2013.0589.
Orsama AL, Lähteenmäki J, Harno K, Kulju M, Wintergerst E, Schachner H, Stenger P, et al. (2013). Active assistance technology reduces glycosylated he-moglobin and weight in individuals with type 2 diabetes: results of a theory-based randomized trial.Diabetes Technol. Ther. 15(8), 662–669. Doi: 10.1089/dia.2013.0056.
Peimani M, Rambod C, Omidvar M, Lari-jani B, Ghodssi-Ghassemabadi R, Tootee A, Esfahani EN (2016). Effectiveness of short message service-based intervention (SMS) on self-care in type 2 diabetes: A feasibility study. Prim. Care Diabetes. 10(4), 251–258.
Shahid M, Mahar SA, Shaikh S, dan Shaikh Z (2015). Mobile phone intervention to improve diabetes care in rural areas of Pakistan: a randomized controlled trial. J Coll Physicians Surg Pak. 25(3): 166–171. PMID: 25772954.
Steventon A, Bardsley M, Doll H, Tuckey E dan Newman S. (2014). Effect of telehealth on glycaemic control: analysis of patients with tipe 2 diabetes in the Whole Systems Demonstrator cluster randomised trial. BMC Heal Serv Res. 14(1): 1–12. Doi: 10.1186/1472696314334.
Tamban C, IsipTan IT, Jimeno C (2013). Use of Short Message Services (SMS) for the Management of Type 2 Diabetes Mellitus: A Randomized Controlled Trial. Jafes. 28(2):1439.
Torbjørnsen A, Jenum AK, Småstuen MC, Arsand E, Holmen H, Wahl AK, Ribu LI (2014). A Low-Intensity Mobile Health Intervention With And Without Health Counseling For Persons With Type 2 Diabetes, Part 1: Baseline And Short-Term Results From A Randomized Controlled Trial In The Norwegian Part Of Renewing Health. Jmir Mhealth Uhealth. 2(4):1–17. Doi: 10.2196/mhealth.3535.