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. 2023 May 31;2023(5):CD014513. doi: 10.1002/14651858.CD014513

Tildesley 2011.

Study characteristics
Methods Efficacy of A1C reduction using internet intervention in patients with type 2 diabetes treated with insulin
RCT (NA clusters and NA providers), conducted in 1) Internet‐based glucose monitoring system (IBGMS) intervention delivered in Vancouver, British Columbia, Canada. 2) Patients received feedback from their endocrinologist. In Canada.
2 arms: 1. Control (conventional care) (control arm) and 2. Intervention (Internet‐based glucose monitoring system‐IBGMS) (intervention arm)
Participants Control arm N: 25
Intervention arm N: 25, NA, NA
Diabetes type: 2
Mean age: 59.5 ± NR
% Male: 63.04
Longest follow‐up: 12 months
Interventions Control arm: (conventional care)
1) Facilitated relay of clinical information
2) Promotion of self‐management
Intervention arm: (Internet‐based glucose monitoring system‐IBGMS)
1) Electronic patient registry
2) Facilitated relay of clinical information
3) Promotion of self‐management
4) Patient reminders
Outcomes Glycated haemoglobin
Funding source This work was supported by Endocrine Research Society (Vancouver, British Columbia), which received funding from ALR Technologies Inc. We extend our appreciation to Abbott Diabetes Care Inc. for their generous gifts of glucose meters and test strips.
Notes
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Patients were randomly assigned to IBGMS or a control group for 6 months using a computer random number generator.
Allocation concealment (selection bias) Unclear risk Not reported.
Patient's baseline characteristics (selection bias) Low risk Table 1. All P values above 0.05.
Patient's baseline outcomes (selection bias) Low risk Table 1. HbA1c has a P value of 0.42.
Incomplete outcome data (attrition bias) Low risk We enrolled 50 patients. Four patients (2 from each group) were excluded because they were nonadherent. Lost 8% in each group. Low and balanced numbers.
Blinding of participants and personnel (performance bias) and of outcome assessors (detection bias) Low risk Our outcome of interest was objectively measured (HbA1c).
Selective reporting (reporting bias) Unclear risk No registered or published protocol. Results match methods.
Risk of contamination (other bias) Unclear risk All patients met with the same endocrinologist and were provided with standard office‐based care. All patients were provided with a blood glucose meter and test strips. Neither group was taught how to interpret SMBG results, although as part of the inclusion criteria, all patients had completed prior training in SMBG. It should be noted that all patients attend a comprehensive 4‐day education course when diagnosed with diabetes.
Other bias Low risk None identified.