Telemedicine with advanced communication technology in management of type 2 diabetes mellitus: a network meta-analysis

Background Type 2 diabetes mellitus has risen to one of the most common chronic diseases worldwide, which puts heavy pressure on patients and the health-care system. Self-management is an important treatment for type 2 diabetes. New self-management treatments have been making great progress with the development of the advanced telemedicine. Objective The purpose of this study is to gauge and examine the blood glucose control of various self-management strategies through a network meta-analysis. Methods We search the articles through PubMed, Cochrane library, MEDLINE, and EMBASE databases to seek out randomized controlled trials, and the primary outcome was the change in HbA1c from baseline. This meta-analysis was conducted to compare different kinds of self-management methods, applying Revman 5.3, Stata 14.0 software, and GeMTC 0.14.3. Results Thirty-five studies were included, consisting of 5554 type 2 diabetes mellitus patients and 4 interventions including computer-based self-management, telephone-based self-management, telemonitoring self-management, and usual care of clinic. In addition to performance bias, the risk of bias of included studies was low. In network meta-analysis, the computer-based self-management has the highest probability to be the most effective way in diabetes self-management treatments. Conclusion In conclusion, computer-based, telephone-based, and telemonitoring self-management methods are effective self-management methods for type 2 diabetes mellitus. The computer-based self-management method was the most effective compared to the other two self-management methods. Clinical trial registration The detailed protocol was registered in PROSPERO ( https://www.crd.york.ac.uk/PROSPERO ). Registration number was CRD42020186839.