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Comparative effectiveness of telemedicine strategies on type 2 diabetes management: A systematic review and network meta-analysis
Open accessAbstract
The effects of telemedicine strategies on the management of diabetes is not clear. This study aimed to investigate the impact of different telemedicine strategies on glycaemic control management of type 2 diabetes patients. A search was performed in 6 databases from inception until September 2016 for randomized controlled studies that examined the use of telemedicine in adults with type 2 diabetes. Studies were independently extracted and classified according to the following telemedicine strategies: teleeducation, telemonitoring, telecase-management, telementoring and teleconsultation. Traditional and network meta-analysis were performed to estimate the relative treatment effects. A total of 107 studies involving 20,501 participants were included. Over a median of 6 months follow-up, telemedicine reduced haemoglobin A1c (HbA1c) by a mean of 0.43% (95% CI: −0.64% to −0.21%). Network meta-analysis showed that all telemedicine strategies were effective in reducing HbA1c significantly compared to usual care except for telecase-management and telementoring, with mean difference ranging from 0.37% and 0.71%. Ranking indicated that teleconsultation was the most effective telemedicine strategy, followed by telecase-management plus telemonitoring, and finally teleeducation plus telecase-management. The review indicates that most telemedicine strategies can be useful, either as an adjunct or to replace usual care, leading to clinically meaningful reduction in HbA1c.
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“Although previous research has compared the effectiveness of 5 strategies for T2DM management, it has primarily focused on telemedicine within DHIs and compared several independent strategies, without providing a systematic summary of the strategies used in DHIs [37].”
From Assessing the Effectiveness of Digital Health Behavior Strategies on Type 2 Diabetes Management: Systematic Review and Network Meta-Analysis (2025) · cites this paper as [37]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“However, there is currently a lack of categorization and summarization of the strategies used in DHIs for T2DM.”
From Assessing the Effectiveness of Digital Health Behavior Strategies on Type 2 Diabetes Management: Systematic Review and Network Meta-Analysis (2025) · cites this paper as [37]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“Two reviews compared different virtual care strategies and found that no single strategy was superior for reducing HbA1c [20, 48].”
From Effect of virtual care in type 2 diabetes management – a systematic umbrella review of systematic reviews and meta-analysis (2025) · cites this paper as [20]
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“Of the 3 reviews that analysed the effect of teleconsultation interventions vs usual care, all reported significant effects on lowering HbA1c levels [20, 21, 29].”
From Effect of virtual care in type 2 diabetes management – a systematic umbrella review of systematic reviews and meta-analysis (2025) · cites this paper as [20]
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In the citing paper
“Those persons with lower socioeconomic status have a higher risk for developing T2D, worse DM control, and more DM-related complications.1661–1663”
From American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. (2022) · cites this paper as [1663]
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In the citing paper
“According to another network meta-analysis, teleconsultation was significantly more effective over conventional care at lowering HbA1c (−0.64, 95% CI −3.74 to −0.02; I2=98%).4”
From Effectiveness of synchronous teleconsultation for patients with type 2 diabetes mellitus: a systematic review and meta-analysis (2023) · cites this paper as [4]
In the citing paper
“According to a previous review, the most effective telemedicine technique is teleconsultation.4”
From Effectiveness of synchronous teleconsultation for patients with type 2 diabetes mellitus: a systematic review and meta-analysis (2023) · cites this paper as [4]
In the citing paper
“Thus, teleconsultation is a complex intervention, and the heterogeneity of the studies included in this meta-analysis is significant, as previous meta-analyses have also demonstrated.4 6 8”
From Effectiveness of synchronous teleconsultation for patients with type 2 diabetes mellitus: a systematic review and meta-analysis (2023) · cites this paper as [4]
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Measuring inconsistency in meta-analyses
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Cited by
Sorted by citations
Davies, M. J., D’Alessio, D. A., Fradkin, J., Kernan, W. N., Mathieu, C., Mingrone, G., Rossing, P., Tsapas, A., Wexler, D. J., & Buse, J. B. (2018) · Diabetes Care · doi:10.2337/dci18-0033 · Cited by 3,518
Davies, M. J., D’Alessio, D. A., Fradkin, J., Kernan, W. N., Mathieu, C., Mingrone, G., Rossing, P., Tsapas, A., Wexler, D. J., & Buse, J. B. (2018) · Diabetologia · doi:10.1007/s00125-018-4729-5 · Cited by 1,455
Blonde, L., Umpierrez, G. E., Reddy, S. S., McGill, J. B., Berga, S. L., Bush, M., Chandrasekaran, S., DeFronzo, R. A., Einhorn, D., Galindo, R. J., et al. (2022) · Endocrine Practice · doi:10.1016/j.eprac.2022.08.002 · Cited by 507
1. Improving Care and Promoting Health in Populations: Standards of Medical Care in Diabetes—2022
American Diabetes Association Professional Practice Committee (2021) · Diabetes Care · doi:10.2337/dc22-s001 · Cited by 355
1. Improving Care and Promoting Health in Populations: Standards of Medical Care in Diabetes—2020
American Diabetes Association (2019) · Diabetes Care · doi:10.2337/dc20-s001 · Cited by 257
Metadata
- Authors
- Lee, S. W. H., Chan, C. K. Y., Chua, S. S., & Chaiyakunapruk, N.
- Affiliations
- Monash University Malaysia (MY)
- Australian Catholic University (AU)
- University of Malaya (MY)
- Corresponding author
- Lee, Shaun Wen Huey
- Chaiyakunapruk, Nathorn
- Venue
- Scientific Reports
- Published
- 2017-10-04
- Volume
- 7
- Issue
- 1
- Pages
- 12680-12680
- ISSN
- 2045-2322 (ISSN-L)
- PMC
- PMC5627243
- OpenAlex
- W2757460696
- Cited by
- 200
- References
- 50
- Citations by year
- 2026: 10 · 2025: 14 · 2024: 30 · 2023: 19 · 2022: 52 · 2021: 31 · 2020: 18 · 2019: 11 · 2018: 15
- FWCI
- 1.96
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Scientific Reports (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Monash University Research Portal (Monash University) (submittedVersion, cc-by)
- Research Bank (Australian Catholic University) (submittedVersion, cc-by)
- Funders
- Kementerian Sains, Teknologi dan Inovasi
- Ministério da Ciência, Tecnologia e Inovação
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- telemedicine, type 2 diabetes, glycemic control, HbA1c, remote patient monitoring, teleconsultation, distance education, telementoring, diabetes management
- MeSH terms
- Diabetes Mellitus, Type 2, Female, Humans, Male, Middle Aged, Outcome Assessment, Health Care, Telemedicine, Publication Bias
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