title: Online social networking services in the management of patients with diabetes mellitus: systematic review and meta-analysis of randomised controlled trials.
abstract: OBJECTIVE
  Social networking services (SNS) can facilitate real-time communication and feedback of blood glucose and other physiological data between patients and healthcare professionals. This systematic review and meta-analysis aims to summarise the current evidence surrounding the role of online social networking services in diabetes care.
  
  
  METHODS
  We performed a systematic literature review of the Medline, EMBASE and PsychINFO databases of all studies reporting HbA1c (glycated haemoglobin) as a measure of glycaemic control for social networking services in diabetes care. HbA1c, clinical outcomes and the type of technology used were extracted. Study quality and publication bias were assessed.
  
  
  RESULTS
  SNS interventions beneficially reduced HbA1c when compared to controls, which was confirmed by sensitivity analysis. SNS interventions also significantly improved systolic and diastolic blood pressure, triglycerides and total cholesterol. Subgroup analysis according to diabetes type demonstrated that Type 2 diabetes patients had a significantly greater reduction in HbA1c than those with Type 1 diabetes.
  
  
  CONCLUSIONS
  Online SNS provide a novel, feasible approach to improving glycaemic control, particularly in patients with Type 2 diabetes. Further mechanistic and cost-effectiveness studies are required to improve our understanding of SNS and its efficacy in diabetes care.
authors.affiliation: The Department of Surgery and Cancer, Imperial College London, 10th Floor, Queen Elizabeth the Queen Mother (QEQM) Building, St Mary's Hospital, Praed Street, London W2 1NY, UK.
authors.forename: Tania
authors.initials: T
authors.lastname: Toma
authors.affiliation: The Department of Surgery and Cancer, Imperial College London, 10th Floor, Queen Elizabeth the Queen Mother (QEQM) Building, St Mary's Hospital, Praed Street, London W2 1NY, UK.
authors.forename: Thanos
authors.initials: T
authors.lastname: Athanasiou
authors.affiliation: The Department of Surgery and Cancer, Imperial College London, 10th Floor, Queen Elizabeth the Queen Mother (QEQM) Building, St Mary's Hospital, Praed Street, London W2 1NY, UK.
authors.forename: Leanne
authors.initials: L
authors.lastname: Harling
authors.affiliation: The Department of Surgery and Cancer, Imperial College London, 10th Floor, Queen Elizabeth the Queen Mother (QEQM) Building, St Mary's Hospital, Praed Street, London W2 1NY, UK.
authors.forename: Ara
authors.initials: A
authors.lastname: Darzi
authors.affiliation: The Department of Surgery and Cancer, Imperial College London, 10th Floor, Queen Elizabeth the Queen Mother (QEQM) Building, St Mary's Hospital, Praed Street, London W2 1NY, UK. Electronic address: h.ashrafian@imperial.ac.uk.
authors.forename: Hutan
authors.initials: H
authors.lastname: Ashrafian
mesh_terms: D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis / Q000628:therapy; D019468:Disease Management; D006801:Humans; D020407:Internet; D016032:Randomized Controlled Trials as Topic; D060756:Social Networking; D017216:Telemedicine / Q000379:methods*
keywords: Diabetes; HbA1c; Social networking services; Telemedicine