Pub Date : 2025-06-03DOI: 10.1016/j.pcd.2025.05.011
Veronica J. Brady , Samuel Akyirem , Nikhil Padhye
Aims
This study aimed to determine prescribing patterns for newer antihyperglycemic agents among racial and ethnic minorities with type 2 diabetes (T2DM) using the All of Us study data.
Methods
We conducted a cross-sectional analysis of electronic health records (EHR) data obtained from the All of Us research study data. We included data from 20,016 persons with T2DM. Participants were eligible for the study if they were 18 years or older, living with T2DM, and had complete data on all variables of interest.
Results
Participants in the study were more likely to be > 55 years of age, identify as female, and non-Hispanic White. Nearly half of the participants were married or partnered and had a household income of less than $35,000 annually. Most participants had hypertension and obesity. Non-Hispanic Blacks had 14 % less odds of having a current or previous prescription of SGLT-2i and 28 % lower odds of receiving a prescription for a GLP-1RA.
Conclusions
Despite known benefits to mitigating the risk for cardiorenal complications related to diabetes, there continue to be disparities in the prescribing of newer antihyperglycemic medications for racial and ethnic minorities.
目的：本研究旨在利用All of Us研究数据，确定少数种族和民族2型糖尿病（T2DM）患者新型降糖药的处方模式。方法：我们对从“我们所有人”研究数据中获得的电子健康记录（EHR）数据进行了横断面分析。我们纳入了20,016例T2DM患者的数据。如果参与者年满18岁或以上，患有2型糖尿病，并且对所有感兴趣的变量有完整的数据，则他们有资格参加研究。结果：研究参与者更有可能是b> 55岁，女性和非西班牙裔白人。近一半的参与者已婚或有伴侣，家庭年收入低于3.5万美元。大多数参与者患有高血压和肥胖。非西班牙裔黑人目前或以前服用SGLT-2i的几率低14% %，服用GLP-1RA的几率低28% %。结论：尽管已知可以降低与糖尿病相关的心肾并发症的风险，但在种族和少数民族的新型降糖药物处方上仍然存在差异。
{"title":"Racial and ethnic differences in prescribing antihyperglycemic medications to persons with type 2 diabetes: An all of us cohort study","authors":"Veronica J. Brady , Samuel Akyirem , Nikhil Padhye","doi":"10.1016/j.pcd.2025.05.011","DOIUrl":"10.1016/j.pcd.2025.05.011","url":null,"abstract":"<div><h3>Aims</h3><div>This study aimed to determine prescribing patterns for newer antihyperglycemic agents among racial and ethnic minorities with type 2 diabetes (T2DM) using the All of Us study data.</div></div><div><h3>Methods</h3><div><span>We conducted a cross-sectional analysis of electronic health records (EHR) data obtained from the All of Us research study data. We included data from 20,016 persons with </span>T2DM. Participants were eligible for the study if they were 18 years or older, living with T2DM, and had complete data on all variables of interest.</div></div><div><h3>Results</h3><div>Participants in the study were more likely to be > 55 years of age, identify as female, and non-Hispanic White. Nearly half of the participants were married or partnered and had a household income of less than $35,000 annually. Most participants had hypertension and obesity. Non-Hispanic Blacks had 14 % less odds of having a current or previous prescription of SGLT-2i and 28 % lower odds of receiving a prescription for a GLP-1RA.</div></div><div><h3>Conclusions</h3><div>Despite known benefits to mitigating the risk for cardiorenal complications related to diabetes, there continue to be disparities in the prescribing of newer antihyperglycemic medications for racial and ethnic minorities.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 5","pages":"Pages 504-511"},"PeriodicalIF":2.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-27DOI: 10.1016/j.pcd.2025.05.008
Olaf Chresten Jensen , Nailet Delgado Mujica , Bishal Gyawali , Finn Gyntelberg
One-third to one-half of seafarers and other transport workers have prediabetes. The initiative described herein aims to incorporate glucometer tests into the routine health examinations and offers a structured 16-week intervention plan. Gold-standard diagnostic techniques such as A1c testing are often excluded from routine health examinations, which leads to missed opportunities to prevent diabetes. Using affordable glucometer technology, by comparison, would enable early diagnosis and the initiation of prediabetes remission coaching programmes. Regularly monitoring fitness and dietary health plans, along with the self-monitoring of blood glucose, is both feasible and beneficial for long-term health management.
{"title":"Using glucometers to assess lifestyle-mediated prediabetes remission in health examinations for students and workers","authors":"Olaf Chresten Jensen , Nailet Delgado Mujica , Bishal Gyawali , Finn Gyntelberg","doi":"10.1016/j.pcd.2025.05.008","DOIUrl":"10.1016/j.pcd.2025.05.008","url":null,"abstract":"<div><div>One-third to one-half of seafarers and other transport workers have prediabetes. The initiative described herein aims to incorporate glucometer tests into the routine health examinations and offers a structured 16-week intervention plan. Gold-standard diagnostic techniques such as A1c testing are often excluded from routine health examinations, which leads to missed opportunities to prevent diabetes. Using affordable glucometer technology, by comparison, would enable early diagnosis and the initiation of prediabetes remission coaching programmes. Regularly monitoring fitness and dietary health plans, along with the self-monitoring of blood glucose, is both feasible and beneficial for long-term health management.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 4","pages":"Pages 405-407"},"PeriodicalIF":2.6,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-24DOI: 10.1016/j.pcd.2025.05.009
Riza Amalia, Ronal Surya Aditya, Rizka Apriani, Salmiati
Type 2 diabetes mellitus is a growing global health challenge, particularly in low- and middle-income countries. The recent study by Seidel-Jacobs et al. highlights the effectiveness of the German Diabetes Risk Score (GDRS) in enhancing lifestyle counseling and shared decision-making in primary care. This letter emphasizes the importance of integrating risk assessment tools with cognitive behavioral therapy (CBT) approaches in counseling to address both behavior and the underlying negative thought patterns that contribute to diabetes risk. Adapting such models to diverse populations, especially in regions like Southeast Asia, could improve early intervention and diabetes prevention efforts globally.
{"title":"The German Diabetes Risk Score (GDRS) in action: Bridging risk stratification with cognitive behavioral lifestyle counseling","authors":"Riza Amalia, Ronal Surya Aditya, Rizka Apriani, Salmiati","doi":"10.1016/j.pcd.2025.05.009","DOIUrl":"10.1016/j.pcd.2025.05.009","url":null,"abstract":"<div><div>Type 2 diabetes mellitus is a growing global health challenge, particularly in low- and middle-income countries. The recent study by Seidel-Jacobs et al. highlights the effectiveness of the German Diabetes Risk Score (GDRS) in enhancing lifestyle counseling and shared decision-making in primary care. This letter emphasizes the importance of integrating risk assessment tools with cognitive behavioral therapy (CBT) approaches in counseling to address both behavior and the underlying negative thought patterns that contribute to diabetes risk. Adapting such models to diverse populations, especially in regions like Southeast Asia, could improve early intervention and diabetes prevention efforts globally.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 4","pages":"Pages 408-409"},"PeriodicalIF":2.6,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diabetic sensorimotor peripheral neuropathy causes patients to have foot injuries without realizing it. This condition may progress to diabetic foot ulcer; infections can include osteomyelitis and lower limb amputations. Managing diabetes and screening diabetic neuropathy is crucial to reducing patient mortality, quality of life, functionality, and the cost burden of complications to the healthcare system. We aim to contribute to the literature by comparing diagnostic methods and examining parameters that can predict neuropathy early.
Material and methods
A total of 108 patients with a neuropathy score Douleur Neuropathique-4 (DN-4) above 4, 54 with known diabetes, and 54 with prediabetes were included. Fasting plasma glucose, oral glucose tolerance test, hemoglobin A1c (HbA1c), LDL-cholesterol, HDL-cholesterol, triglyceride, uric acid, vitamin B12, folic acid, creatinine, and complete urinalysis was performed on 108 patients included. Afterward, a monofilament test, tuning fork test, and electromyography were performed by the neurologist to prove neuropathy.
Results
The frequency of neuropathy in the prediabetes group was found to be 0.40 ± 0.49 % using EMG. This rate is 0.71 ± 0.45 % for diabetic neuropathy. The difference is statistically significant (p = 0.001) in the prediabetic group, the neuropathy score (DN-4 score) was 5.1 ± 0.9, the tuning fork test positivity was 0.18 ± 0.39, and p = 0.001 was statistically significant compared to the diabetic group. Also, in the monofilament test, the rate of neuropathy in the prediabetes group was again statistically significant with 0.68 ± 0.47 (p = 0.027). Total cholesterol (185.1 ± 21.8, p = 0.003), high uric acid (5.11 ± 1.27, p = 0.003), and low folic acid (4.5 ± 1.05, p = 0.026) are found to be statistically significant between diabetic and prediabetic groups.
Discussion and conclusion
In diagnosing neuropathy, monofilament, and diapason testing can be used in the clinical setting, and they have been found to be successful tests in the diagnosis of neuropathy. Also, our analysis indicates the relationship between low folic acid, high total cholesterol/uric acid levels, and prediabetic neuropathy. The role of intervening blood levels of those factors with medications in preventing neuropathy is unclear. We recommend further investigating all the patient’s dietary habits to find possible risk factors, as well as investigating patients with low folic acid and high total cholesterol/ uric acid levels much more cautiously.
Recommendation
Neuropathy should be screened in prediabetic and diabetic patients, and possible risk factors should be assessed periodically.
{"title":"The frequency of neuropathy and predictive parameters in prediabetic cases from Turkiye","authors":"Baris Emekdas , Canan Celebi , Batuhan Cakmak , Soner Duman , Ilgin Yildirim Simsir","doi":"10.1016/j.pcd.2025.05.007","DOIUrl":"10.1016/j.pcd.2025.05.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Diabetic sensorimotor peripheral neuropathy causes patients to have foot injuries without realizing it. This condition may progress to diabetic foot ulcer; infections can include osteomyelitis and lower limb amputations. Managing diabetes and screening diabetic neuropathy is crucial to reducing patient mortality, quality of life, functionality, and the cost burden of complications to the healthcare system. We aim to contribute to the literature by comparing diagnostic methods and examining parameters that can predict neuropathy early.</div></div><div><h3>Material and methods</h3><div>A total of 108 patients with a neuropathy score Douleur Neuropathique-4 (DN-4) above 4, 54 with known diabetes, and 54 with prediabetes were included. Fasting plasma glucose, oral glucose tolerance test, hemoglobin A1c (HbA1c), LDL-cholesterol, HDL-cholesterol, triglyceride, uric acid, vitamin B12, folic acid, creatinine, and complete urinalysis was performed on 108 patients included. Afterward, a monofilament test, tuning fork test, and electromyography were performed by the neurologist to prove neuropathy.</div></div><div><h3>Results</h3><div>The frequency of neuropathy in the prediabetes group was found to be 0.40 ± 0.49 % using EMG. This rate is 0.71 ± 0.45 % for diabetic neuropathy. The difference is statistically significant (p = 0.001) in the prediabetic group, the neuropathy score (DN-4 score) was 5.1 ± 0.9, the tuning fork test positivity was 0.18 ± 0.39, and p = 0.001 was statistically significant compared to the diabetic group. Also, in the monofilament test, the rate of neuropathy in the prediabetes group was again statistically significant with 0.68 ± 0.47 (p = 0.027). Total cholesterol (185.1 ± 21.8, p = 0.003), high uric acid (5.11 ± 1.27, p = 0.003), and low folic acid (4.5 ± 1.05, p = 0.026) are found to be statistically significant between diabetic and prediabetic groups.</div></div><div><h3>Discussion and conclusion</h3><div>In diagnosing neuropathy, monofilament, and diapason testing can be used in the clinical setting, and they have been found to be successful tests in the diagnosis of neuropathy. Also, our analysis indicates the relationship between low folic acid, high total cholesterol/uric acid levels, and prediabetic neuropathy. The role of intervening blood levels of those factors with medications in preventing neuropathy is unclear. We recommend further investigating all the patient’s dietary habits to find possible risk factors, as well as investigating patients with low folic acid and high total cholesterol/ uric acid levels much more cautiously.</div></div><div><h3>Recommendation</h3><div>Neuropathy should be screened in prediabetic and diabetic patients, and possible risk factors should be assessed periodically.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 4","pages":"Pages 400-404"},"PeriodicalIF":2.6,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-14DOI: 10.1016/j.pcd.2025.05.006
Jonathan Goldney , Eka Melson , Ansh Verma , Kamlesh Khunti , Francesco Zaccardi , Melanie J. Davies , Samuel Seidu
It remains unclear whether the prevalence and incidence of complications varies with ethnicity in individuals with early-onset type 2 diabetes. We undertook a systematic review to investigate. We identified sparse published data, with no clear findings. More prospective studies are needed. Epidemiological studies should routinely stratify by ethnicity.
{"title":"The association between ethnicity and complications in individuals with early-onset type 2 diabetes: A systematic review","authors":"Jonathan Goldney , Eka Melson , Ansh Verma , Kamlesh Khunti , Francesco Zaccardi , Melanie J. Davies , Samuel Seidu","doi":"10.1016/j.pcd.2025.05.006","DOIUrl":"10.1016/j.pcd.2025.05.006","url":null,"abstract":"<div><div>It remains unclear whether the prevalence and incidence of complications varies with ethnicity in individuals with early-onset type 2 diabetes. We undertook a systematic review to investigate. We identified sparse published data, with no clear findings. More prospective studies are needed. Epidemiological studies should routinely stratify by ethnicity.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 4","pages":"Pages 355-359"},"PeriodicalIF":2.6,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-14DOI: 10.1016/j.pcd.2025.05.003
Mats Baxter , Nicholas Conway , Alex Bickerton , Scott Cunningham , Scott C. MacKenzie , Jane Dickson , Doogie Brodie , Christopher Sainsbury , Deborah J. Wake
Background
The MyWay Diabetes (MWD) digital platform aims to improve diabetes management through personalised access to health records, structured education, and other self-management features.
Purpose
We aimed to assess health outcomes in MWD users with type 1 diabetes (T1DM) and type 2 diabetes (T2DM) over 6 years of use.
Methods
An interrupted time-series analysis in MWD users with T1DM or T2DM in Somerset, UK, compared pre- and post-MWD registration trends to estimate differences in health outcomes (HbA1c, blood pressure, lipids, BMI, weight). Generalised estimating equations modelling adjusted for participant baseline characteristics and identified significant predictors.
Results
A total of 7207 people (T1DM: n = 750 (52.3 % female, mean age 51.2 (SD15.8)), T2DM: n = 6457 (58.1 % male, mean age 64.7 (SD12.0))) were included in the analysis. The study showed some health outcomes improved significantly for T2DM between pre- and post-MWD registration. HbA1c reduced by 8.6 mmol/mol at 24 months post-MWD registration, with greatest improvements observed in users who were younger, had shorter diabetes durations and who were frequent MWD users. All health outcomes for T1DM were unchanged.
Conclusion
The large HbA1c reduction for T2DM is notable for a scalable digitally-enabled self-management intervention and adds to the evidence base for digital interventions for diabetes self-management.
背景：MyWay Diabetes （MWD）数字平台旨在通过个性化访问健康记录、结构化教育和其他自我管理功能来改善糖尿病管理。目的：我们旨在评估合并1型糖尿病（T1DM）和2型糖尿病（T2DM）的MWD使用者使用6年以上的健康结果。方法：对英国萨默塞特（Somerset）患有1型糖尿病或2型糖尿病的MWD患者进行中断时间序列分析，比较MWD前后登记趋势，以估计健康结局（HbA1c、血压、血脂、BMI、体重）的差异。广义估计方程模型调整了参与者基线特征并确定了重要的预测因子。结果：共纳入7207人(T1DM: n = 750（女性52.3 %，平均年龄51.2 （SD15.8)）， T2DM: n = 6457（男性58.1 %，平均年龄64.7 (SD12.0)））。研究显示，在mwd登记前后，T2DM患者的一些健康结果显著改善。在MWD登记后24个月，HbA1c降低了8.6 mmol/mol，在年轻、糖尿病持续时间较短和频繁使用MWD的用户中观察到最大的改善。T1DM的所有健康结果没有变化。结论：T2DM患者HbA1c的大幅降低对于可扩展的数字化自我管理干预是值得注意的，并为数字化糖尿病自我管理干预提供了证据基础。
{"title":"Impact on diabetes-related health outcomes using a digitally-enabled diabetes self-management platform in Somerset, UK: An interrupted time-series analysis","authors":"Mats Baxter , Nicholas Conway , Alex Bickerton , Scott Cunningham , Scott C. MacKenzie , Jane Dickson , Doogie Brodie , Christopher Sainsbury , Deborah J. Wake","doi":"10.1016/j.pcd.2025.05.003","DOIUrl":"10.1016/j.pcd.2025.05.003","url":null,"abstract":"<div><h3>Background</h3><div>The MyWay Diabetes (MWD) digital platform aims to improve diabetes management through personalised access to health records, structured education, and other self-management features.</div></div><div><h3>Purpose</h3><div>We aimed to assess health outcomes in MWD users with type 1 diabetes (T1DM) and type 2 diabetes (T2DM) over 6 years of use.</div></div><div><h3>Methods</h3><div>An interrupted time-series analysis in MWD users with T1DM or T2DM in Somerset, UK, compared pre- and post-MWD registration trends to estimate differences in health outcomes (HbA1c, blood pressure, lipids, BMI, weight). Generalised estimating equations modelling adjusted for participant baseline characteristics and identified significant predictors.</div></div><div><h3>Results</h3><div>A total of 7207 people (T1DM: n = 750 (52.3 % female, mean age 51.2 (SD15.8)), T2DM: n = 6457 (58.1 % male, mean age 64.7 (SD12.0))) were included in the analysis. The study showed some health outcomes improved significantly for T2DM between pre- and post-MWD registration. HbA1c reduced by 8.6 mmol/mol at 24 months post-MWD registration, with greatest improvements observed in users who were younger, had shorter diabetes durations and who were frequent MWD users. All health outcomes for T1DM were unchanged.</div></div><div><h3>Conclusion</h3><div>The large HbA1c reduction for T2DM is notable for a scalable digitally-enabled self-management intervention and adds to the evidence base for digital interventions for diabetes self-management.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 4","pages":"Pages 360-367"},"PeriodicalIF":2.6,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This systematic review aims to assess the effectiveness of AI-Driven Decision Support Systems in improving glycemic control, measured by Time in Range (TIR) and HbA1c levels, in patients with diabetes. Included studies were randomized controlled trials (RCTs) that evaluated AI interventions in diabetes management. Exclusion criteria included non-English studies, non-peer-reviewed articles. Studies were identified by searching electronic databases including PubMed, EMBASE, and Cochrane Library up to December 2024. Risk of bias was assessed using the Cochrane Risk of Bias tool for RCTs. Results were synthesized using a random-effects meta-analysis model. The review included 17 RCTs with a total of 3381 participants in the intervention group and 3176 in the control group. AI interventions were found to significantly improve TIR and reduce HbA1c levels. The meta-analysis for TIR yielded a mean difference of 0.54 (95 % CI: 0.05–1.03), and for HbA1c a standardized mean difference of –0.91 (95 % CI: –1.23 to –0.58). Evidence was limited by high heterogeneity (I² > 90 % for both outcomes) and indications of publication bias, which may overestimate the effectiveness reported. Despite limitations, the results support the potential of AI interventions in enhancing diabetes management, though variability in effectiveness suggests the need for personalized approaches.
{"title":"Effectiveness of AI-driven interventions in glycemic control: A systematic review and meta-analysis of randomized controlled trials","authors":"Khadija Elmotia, Oumaima Abouyaala, Soukaina Bougrine, Moulay Laarbi Ouahidi","doi":"10.1016/j.pcd.2025.05.004","DOIUrl":"10.1016/j.pcd.2025.05.004","url":null,"abstract":"<div><div>This systematic review aims to assess the effectiveness of AI-Driven Decision Support Systems in improving glycemic control, measured by Time in Range (TIR) and HbA1c levels, in patients with diabetes. Included studies were randomized controlled trials (RCTs) that evaluated AI interventions in diabetes management. Exclusion criteria included non-English studies, non-peer-reviewed articles. Studies were identified by searching electronic databases including PubMed, EMBASE, and <em>Cochrane</em> Library up to December 2024. Risk of bias was assessed using the Cochrane Risk of Bias tool for RCTs. Results were synthesized using a random-effects meta-analysis model. The review included 17 RCTs with a total of 3381 participants in the intervention group and 3176 in the control group. AI interventions were found to significantly improve TIR and reduce HbA1c levels. The meta-analysis for TIR yielded a mean difference of 0.54 (95 % CI: 0.05–1.03), and for HbA1c a standardized mean difference of –0.91 (95 % CI: –1.23 to –0.58). Evidence was limited by high heterogeneity (I² > 90 % for both outcomes) and indications of publication bias, which may overestimate the effectiveness reported. Despite limitations, the results support the potential of AI interventions in enhancing diabetes management, though variability in effectiveness suggests the need for personalized approaches.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 4","pages":"Pages 345-354"},"PeriodicalIF":2.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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