Objective

To compare outcomes associated with patient education about glycemic control via group chat versus patient education as usual among individuals with diabetes in China.

Methods

We searched the following databases both in English and in Chinese languages: PubMed, CNKI, Wanfang database, VIP database, and CBM for articles published up to Jan 1, 2018. The studies were screened by two independent reviewers. Using criteria from the risk of bias assessment tool developed by Cochrane Collaboration to assess the risk of bias of eligible studies. A meta-analysis of studies was performed using comprehensive meta-analysis version 3.0.

Results

Twenty-five unique randomized clinical trials, including 2,838 patients, were identified. The education delivered via group chat had large overall pooled effect sizes in improving glucose control measured by hemoglobin A1c [Hedges' g = -0.81, 95% CI: (-0.98, -0.64)], fasting blood glucose [Hedges' g = -1.11, 95% CI: (-1.37, -0.85)], and 2 h postprandial blood glucose [Hedges' g = -0.98, 95% CI: (-1.20, -0.76)]. Additionally, patient education delivered via group chat has shown consistently superior outcomes in glucose control in short-term (0-3 months), mid-term (3-6 months) and longer-term (6-12 months).

Conclusions

Educational interventions via group chat had a superior outcome in blood glucose control compared to education as usual in China. Educational interventions via group chat had superior short-term, mid-term, and longer-term outcomes in blood glucose control compared to education as usual in China.

Root-microbiome interactions are of central importance for plant performance and yield. A distinctive feature of legumes is that they engage in symbiosis with N₂-fixing rhizobia. If and how the rhizobial symbiotic capacity modulates root-associated microbiomes are still not yet well understood. We determined root-associated microbiomes of soybean inoculated with wild type (WT) or a noeI mutant of Bradyrhizobium diazoefficiens USDA 110 by amplicon sequencing. UPLC-MS/MS was used to analyze root exudates. The noeI gene is responsible for fucose-methylation of Nod factor secreted by USDA 110 WT strain. Soybean roots inoculated with the noeI mutant showed a significant decrease in nodulation and root-flavonoid exudation compared to roots inoculated with WT strain. The noeI mutant-inoculated roots exhibited strong changes in microbiome assembly in the rhizosphere and rhizoplane, including reduced diversity, changed co-occurrence interactions and a substantial depletion of root microbes. Root exudates and soil physiochemical properties were significantly correlated with microbial community shift in the rhizosphere between different rhizobial treatments. These results illustrate that rhizobial symbiotic capacity dramatically alters root-associated microbiomes, in which root exudation and edaphic patterns play a vital role. This study has important implications for understanding the evolution of plant-microbiome interactions.