title: Impact of Information Technology-Based Interventions for Type 2 Diabetes Mellitus on Glycemic Control: A Systematic Review and Meta-Analysis.
abstract: 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.
  
  
  
  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.
  
  
  
  Electronic databases PubMed and EMBASE were searched to identify relevant studies that were published up until July 2016, a method that was supplemented by identifying articles from the references of the articles already selected using the electronic search tools. The study search and selection were performed by independent reviewers. Of the 1082 articles retrieved, 32 trials (focusing on a total of 40,454 patients) were included. A random-effects model was applied to estimate the pooled results.
  
  
  
  Information technology-based interventions were associated with a statistically significant reduction in HbA1clevels (mean difference -0.33%, 95% CI -0.40 to -0.26, P<.001). Studies focusing on electronic self-management systems demonstrated the largest reduction in HbA1c(0.50%), followed by those with electronic medical records (0.17%), an electronic decision support system (0.15%), and a diabetes registry (0.05%). In addition, the more CCM-incorporated the information technology-based interventions were, the more improvements there were in HbA1clevels.
  
  
  
  Information technology strategies combined with the other elements of chronic care models are associated with improved glycemic control in people with diabetes. No clinically relevant impact was observed on low-density lipoprotein levels and blood pressure, but there was evidence that the cost of care was lower.
authors.affiliation: King Saud University, Riyadh, Saudi Arabia.|University of Surrey, Guildford, United Kingdom.
authors.forename: Nouf Sahal
authors.identifier: 0000-0002-4431-3303
authors.initials: NS
authors.lastname: Alharbi
authors.affiliation: King Saud University, Riyadh, Saudi Arabia.
authors.forename: Nada
authors.identifier: 0000-0001-7826-0564
authors.initials: N
authors.lastname: Alsubki
authors.affiliation: University of Surrey, Guildford, United Kingdom.
authors.forename: Simon
authors.identifier: 0000-0002-8267-5647
authors.initials: S
authors.lastname: Jones
authors.affiliation: University of Leicester, Leicester, United Kingdom.
authors.forename: Kamlesh
authors.identifier: 0000-0003-2343-7099
authors.initials: K
authors.lastname: Khunti
authors.affiliation: University of Surrey, Guildford, United Kingdom.
authors.forename: Neil
authors.initials: N
authors.lastname: Munro
authors.affiliation: University of Surrey, Guildford, United Kingdom.
authors.forename: Simon
authors.identifier: 0000-0002-8553-2641
authors.initials: S
authors.lastname: de Lusignan
mesh_terms: D001786:Blood Glucose / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000628:therapy*; D006442:Glycated Hemoglobin / Q000378:metabolism*; D000067940:Glycemic Load; D006801:Humans; D008490:Medical Informatics / Q000379:methods*
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin
keywords: diabetes mellitus; medical informatics applications; technology