Cited by 102Telemedicine and Telehealth ImplementationDiabetes Management and EducationDiabetes Management and Research

The Empirical Evidence for the Telemedicine Intervention in Diabetes Management

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Bashshur, Rashid L., Shannon, Gary W., Smith, Brian R., Woodward, Maria A.·2015·Telemedicine and e-Health

Abstract

OBJECTIVE: The research presented here assesses the scientific evidence for the telemedicine intervention in the management of diabetes (telediabetes), gestational diabetes, and diabetic retinopathy. The impetus derives from the confluence of high prevalence of these diseases, increasing incidence, and rising costs, while telemedicine promises to ameliorate, if not prevent, type 2 diabetes and its complications. MATERIALS AND METHODS: A purposeful review of the literature identified relevant publications from January 2005 to December 2013. These were culled to retain only credible research articles for detailed review and analysis. The search yielded approximately 17,000 articles with no date constraints. Of these, 770 appeared to be research articles within our time frame. A review of the abstracts yielded 73 articles that met the criteria for inclusion in the final analysis. Evidence is organized by research findings regarding feasibility/acceptance, intermediate outcomes (e.g., use of service, and screening compliance), and health outcomes (control of glycemic level, lipids, body weight, and physical activity.) RESULTS: Definitions of telediabetes varied from study to study vis-à-vis diabetes subtype, setting, technology, staffing, duration, frequency, and target population. Outcome measures also varied. Despite these vagaries, sufficient evidence was obtained from a wide variety of research studies, consistently pointing to positive effects of telemonitoring and telescreening in terms of glycemic control, reduced body weight, and increased physical exercise. The major contributions point to telemedicine's potential for changing behaviors important to diabetes control and prevention, especially type 2 and gestational diabetes. Similarly, screening and monitoring for retinopathy can detect symptoms early that may be controlled or treated. CONCLUSIONS: Overall, there is strong and consistent evidence of improved glycemic control among persons with type 2 and gestational diabetes as well as effective screening and monitoring of diabetic retinopathy.

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  1. Peters A. Overcoming challenges and improving outcomes in the management of type 2 diabetes. J Managed Care Med 2012;15:52-55.
  2. Stamp K, Allen N, Lehrer S, et al. Telehealth program for Medicaid patients with type 2 diabetes lowers hemoglobin A1C. J Managed Care Med 2012;15:38-49.
  3. Wier LM, Witt E, Burgess J, Elixhauser A. Hospitalizations related to diabetes in pregnancy, 2008. Statistical Brief #102, December 2010. In: Healthcare Cost and Utilization Project (HCUP) statistical briefs. Rockville, MD: Agency for Health Care Policy and Research, 2006. Available at www.ncbi.nlm.nih.gov/ books/NBK52649/ (last accessed February 25, 2015).
  4. Gillespie P, Cullinan J, O'Neukk G, Dunne F. Modeling the independent effects of gestational diabetes on maternity care and costs. Diabetes Care 2012;36:1111-1116.

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Authors
Bashshur, R. L., Shannon, G. W., Smith, B. R., & Woodward, M. A.
Affiliations
  • Michigan Medicine (US)
  • University of Kentucky (US)
  • University of Michigan (US)
Corresponding author
Bashshur, Rashid L.
Venue
Telemedicine and e-Health
Published
2015-05
Volume
21
Issue
5
Pages
321-354
ISSN
  • 1530-5627 (ISSN-L)
  • 1556-3669
OpenAlex
W2072335042
Cited by
102
References
124
Citations by year
2026: 2 · 2025: 6 · 2024: 9 · 2023: 9 · 2022: 3 · 2021: 11 · 2020: 12 · 2019: 12 · 2018: 11 · 2017: 5 · 2016: 15 · 2015: 7
FWCI
13.55
Type
journal article
Language
en
Open access
Locations
  • Telemedicine Journal and e-Health (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Deep Blue (University of Michigan) (submittedVersion)
Funders
  • National Institutes of Health
  • National Eye Institute (K23EY023596)
  • National Institute of Diabetes and Digestive and Kidney Diseases (P30DK092926)
  • U.S. National Library of Medicine
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, gestational diabetes mellitus, diabetic retinopathy, remote patient monitoring, telescreening, glycemic control, weight loss, physical activity, diabetes prevention, screening adherence
MeSH terms
Diabetes Mellitus, Female, Humans, Male, United States, Telemedicine, Evidence-Based Medicine, Disease Management, Empirical Research

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