In addition , the more CCM-incorporated the information technology-based interventions were , the more improvements there were in HbA1c levels .
CONCLUSIONS Information technology strategies combined with the other elements of chronic care models are associated with improved glycemic control in people with diabetes .
No clinical ly relevant impact was observed on low-density lipoprotein levels and blood pressure , but there was evidence that the cost of care was lower
BACKGROUND Information technology-based interventions are increasingly being used to manage health care .
However , there is conflicting evidence regarding whether these interventions improve outcomes in people with type 2 diabetes .
OBJECTIVE The objective of this study was to conduct a systematic review and meta- analysis of clinical trials , assessing the impact of information technology on changes in the levels of hemoglobin A1c ( HbA1c ) and mapping the interventions with chronic care model ( CCM ) elements .
Biophysiologic outcomes of the Enhancing Adherence in Type 2 Diabetes (ENHANCE) trial.
BACKGROUND Behavioral research to improve lifestyle in broadly defined population s of patients with type 2 diabetes is limited . OBJECTIVE We evaluated a behavioral intervention featuring technology-based self-monitoring on biophysiologic outcomes of glycemic control and markers of cardiovascular risk . DESIGN In this single-site , r and omized clinical trial , participants were stratified by good and poor glycemic control ( glycated hemoglobin < 8 % or ≥8 % ) and absence or presence of kidney disease , ( estimated glomerular filtration rate ≥60 or < 60 mL/min ) and r and omized within strata . Measurements were obtained at 0 , 3 , and 6 months . PARTICIPANTS / SETTING Self-referred , community-dwelling adults with type 2 diabetes mellitus . INTERVENTION The intervention group received Social Cognitive Theory-based counseling paired with technology-based self-monitoring , and results were compared with an attention control group . MAIN OUTCOME MEASURES Glycated hemoglobin , fasting serum glucose , lipid levels , blood pressure , weight , body mass index , and waist circumference were evaluated . STATISTICAL ANALYSES PERFORMED Mean differences within and between r and omization groups were compared over time . Intervention effects over time were estimated using r and om intercept models . RESULTS Two hundred ninety-six subjects were r and omized , 256 ( 86.5 % ) completed 3-month and 246 ( 83.1 % ) completed 6-month assessment s. Glycated hemoglobin was reduced in the intervention group by 0.5 % at 3 months and 0.6 % at 6 months ( P<0.001 for each ) , and the control group by 0.3 % ( P<0.001 ) at 3 months and 0.2 % ( P<0.05 ) at 6 months ; but between-group differences were not significant . In those with baseline glycated hemoglobin ≥8 % and estimated glomerular filtration rate ≥60 mL/min , glycated hemoglobin was reduced in the intervention group by 1.5 % at 3 months and 1.8 % at 6 months ( P<0.001 for each ) , and the control group by 0.9 % ( P<0.001 ) at 3 months and 0.8 % ( P<0.05 ) at 6 months ; but between-group differences were not significant . In r and om intercept models , the estimated reduction in glycated hemoglobin of 0.29 % was not significant . CONCLUSIONS Two behavioral approaches to improving general lifestyle management in individuals with type 2 diabetes mellitus were effective in improving glycemic control , but no significant between-group differences were observed
In addition , the more CCM-incorporated the information technology-based interventions were , the more improvements there were in HbA1c levels .
CONCLUSIONS Information technology strategies combined with the other elements of chronic care models are associated with improved glycemic control in people with diabetes .
No clinical ly relevant impact was observed on low-density lipoprotein levels and blood pressure , but there was evidence that the cost of care was lower
BACKGROUND Information technology-based interventions are increasingly being used to manage health care .
However , there is conflicting evidence regarding whether these interventions improve outcomes in people with type 2 diabetes .
OBJECTIVE The objective of this study was to conduct a systematic review and meta- analysis of clinical trials , assessing the impact of information technology on changes in the levels of hemoglobin A1c ( HbA1c ) and mapping the interventions with chronic care model ( CCM ) elements .