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The Empirical Evidence for the Telemedicine Intervention in Diabetes Management

机译:糖尿病管理中远程医疗干预的经验证据。

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摘要

>Objective: The research presented here assesses the scientific evidence for the telemedicine intervention in the management of diabetes (telediabetes), gestational diabetes, and diabetic retinopathy. The impetus derives from the confluence of high prevalence of these diseases, increasing incidence, and rising costs, while telemedicine promises to ameliorate, if not prevent, type 2 diabetes and its complications. >Materials and Methods: A purposeful review of the literature identified relevant publications from January 2005 to December 2013. These were culled to retain only credible research articles for detailed review and analysis. The search yielded approximately 17,000 articles with no date constraints. Of these, 770 appeared to be research articles within our time frame. A review of the abstracts yielded 73 articles that met the criteria for inclusion in the final analysis. Evidence is organized by research findings regarding feasibility/acceptance, intermediate outcomes (e.g., use of service, and screening compliance), and health outcomes (control of glycemic level, lipids, body weight, and physical activity.) >Results: Definitions of telediabetes varied from study to study vis-à-vis diabetes subtype, setting, technology, staffing, duration, frequency, and target population. Outcome measures also varied. Despite these vagaries, sufficient evidence was obtained from a wide variety of research studies, consistently pointing to positive effects of telemonitoring and telescreening in terms of glycemic control, reduced body weight, and increased physical exercise. The major contributions point to telemedicine's potential for changing behaviors important to diabetes control and prevention, especially type 2 and gestational diabetes. Similarly, screening and monitoring for retinopathy can detect symptoms early that may be controlled or treated. >Conclusions: Overall, there is strong and consistent evidence of improved glycemic control among persons with type 2 and gestational diabetes as well as effective screening and monitoring of diabetic retinopathy.
机译:>目的:此处提出的研究评估了远程医疗干预对糖尿病(telediabetes),妊娠糖尿病和糖尿病性视网膜病变的管理的科学证据。这些疾病的高流行,不断增加的发病率和不断增加的成本相结合,从而推动了这一趋势,而远程医疗有望改善(如果不能预防的话)2型糖尿病及其并发症。 >材料和方法:对文献进行了有目的的审查,确定了2005年1月至2013年12月之间的相关出版物。仅保留了可靠的研究文章进行详细的审查和分析。该搜索产生了大约17,000条没有日期限制的文章。其中有770篇是我们研究范围内的研究文章。对摘要的审查产生了73篇符合最终分析标准的文章。证据是根据有关可行性/接受性,中间结果(例如,使用服务和筛查依从性)以及健康结果(控制血糖水平,脂质,体重和身体活动)的研究结果来组织的。>结果:< / strong>远程糖尿病的定义因研究对象的糖尿病亚型,环境,技术,人员,持续时间,频率和目标人群而异。结果指标也各不相同。尽管存在这些变数,但从各种各样的研究中获得了足够的证据,这些证据始终表明远程监测和远程筛查在控制血糖,减轻体重和增加体育锻炼方面具有积极作用。主要贡献在于远程医疗具有改变对糖尿病控制和预防至关重要的行为的潜力,尤其是2型和妊娠糖尿病。同样,筛查和监测视网膜病变可以及早发现可能被控制或治疗的症状。 >结论:总体而言,有充分而一致的证据表明2型糖尿病和妊娠糖尿病患者的血糖控制得到改善,以及糖尿病性视网膜病变的有效筛查和监测。

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