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The Empirical Evidence for the Telemedicine Intervention in Diabetes Management
Open accessAbstract
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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“Synchronous human coaching has been shown to be effective in glycemic control for patients with T2DM [70] and has been explored in rural-specific settings as well [71,72].”
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The Empirical Evidence for Telemedicine Interventions in Mental Disorders
Bashshur, R. L., Shannon, G. W., Bashshur, N., & Yellowlees, P. (2015) · Telemedicine Journal and e-Health · doi:10.1089/tmj.2015.0206 · Cited by 466
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Telemedicine in Neurological Disorders: Opportunities and Challenges
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“The data clearly indicates that the use of telemedicine is superior to office visits in terms of emergency visits, hospitalizations, complications, and quality of life for diabetes [19], hypertension, pain [20], congestive heart failure [21], cancer care, rehabilitation after stroke [22], and dementia [23].”
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“Rural and underserved populations, often facing challenges in accessing healthcare facilities, can benefit from virtual consultations, reducing travel distances and associated costs (Bashshur et al., 2016).”
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Ivanov, V. G., Nikolaev, E. L., Юрьевна, Л. Е., & Ивановна, Т. А. (2020) · PERSONALITY IN A CHANGING WORLD HEALTH ADAPTATION DEVELOPMENT · doi:10.23888/humj20202160-171 · Cited by 33
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“41,42 Studies suggest that telemedicine can reduce DR-related visual impairment by up to 86%, although further studies are required to verify these findings.”
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“Past systematic reviews on the same topic were mostly performed including all diabetes types in pregnancy (Mastrogiannis et al., 2013; Bashshur et al., 2015; Ming et al., 2016), so the present review provides a more in-depth analysis specific for GDM meant as first diagnosis during pregnancy.”
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Telemedicine and Tele-ICU: The Evolution and Differentiation of a New Medical Field
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Diabetes clinic reinvented: will technology change the future of diabetes care?
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“17,24 As more than 50% of healthcare expenditures for patients with diabetes are related to diabetes complications, healthcare organizations may take advantage of these innovative digital procedures that improve diabetes outcomes and reduce overall healthcare cost.”
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“This clinical approach, which seeks to evaluate telemedicine devices according to the principles of evidence-based medicine [6,7], is further coupled by numerous economic analysis models built around their cost-efficiency.”
Ronca, V., Giorgi, A., Rossi, D., Florio, A. D., Flumeri, G. D., Aricò, P., Sciaraffa, N., Vozzi, A., Tamborra, L., Simonetti, I., et al. (2021) · Sensors · doi:10.3390/s21051607 · Cited by 25
“Nowadays telemedicine platforms are employed in a wide range of medical and clinical applications, such as the diabetes management [1], asthma monitoring [2,3], chronic disease [4,5] and age-related diseases [6,7].”
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Valencia, W. M., Botros, D., Vera-Nunez, M. A., & Dang, S. (2018) · Current Diabetes Reports · doi:10.1007/s11892-018-1052-y · Cited by 26
Telepsychiatry in intellectual disability psychiatry: literature review
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Lu, Z., Li, Y., He, Y., Zhai, Y., Wu, J. H., Wang, J., & Zhao, Z. (2020) · Telemedicine Journal and e-Health · doi:10.1089/tmj.2020.0123 · Cited by 18
Telehealth Adoption Among Endocrinologists During The Covid-19 Pandemic
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Hashemi, A., Nourbakhsh, S., Tehrani, P., & Karimi, A. (2018) · Artery Research · doi:10.1016/j.artres.2018.04.001 · Cited by 17
Review of Systematic Reviews in the Field of Telemedicine
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Integrating and safeguarding care: The potential role of health information technologies
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Development, Technical, and User Evaluation of a Web Mobile Application for Self-Control of Diabetes
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“Moreover, a previous metaanalysis also found that TM intervention showed no significant effect on BP in DM patients.(30) Interestingly, our results showed that the use of TM was associated with improving BP control in patients with CVD and hypertension.”
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“TM may be more beneficial in people with high HbA1c values, since TM can help patients modify their health behaviors such as diet and physical activity by monitoring them [37].”
Koh, Z. W. J., Sim, S. Z., Lew, J. K., Lee, S., & Lee, E. S. (2023) · BMJ Open · doi:10.1136/bmjopen-2022-063094 · Cited by 10
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Altabtabaei, R., & Alhuwail, D. (2023) · JMIR Human Factors · doi:10.2196/46324 · Cited by 9
“It promises patients to deliver remote medical care over long distances at less cost [14].”
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Agreement and Reliability of Patient-measured Postvoid Residual Bladder Volumes
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“A recent paper highlighted the positive impact of telemonitoring on chronic disease management (diabetes, in particular) to monitor patient's conditions and the potential to reduce healthcare costs (Bashshur et al. 2015).”
Tancredi, M., Chrusciel, J., Zaouia, S., Mergey, V., Laplanche, D., & Sanchez, S. (2024) · BMC Health Services Research · doi:10.1186/s12913-024-11726-1 · Cited by 6
“However, despite encouraging results from previous studies [16], the benefits of telemedicine for women with GDM remain uncertain [17, 18].”
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“Numerous medical and therapeutic applications, including diabetes management [31], asthma monitoring [32,33], chronic disease [34,35], and age-related diseases [36,37], employ telemedicine systems.”
Virtual psychiatric care for perinatal depression (Virtual-PND): A pilot randomized controlled trial
Dalfen, A., Wasserman, L., Benipal, P. K., Lawson, A., Young, B., de Oliveira, C., Hensel, J. M., Dennis, C., & Vigod, S. N. (2021) · Journal of Affective Disorders Reports · doi:10.1016/j.jadr.2021.100085 · Cited by 5
“New means of securely providing virtual care in any setting, such as mobile personal device video-conferencing, are emerging ( Bashshur et al., 2015 ).”
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Home monitoring of ovarian stimulation: an important step towards more patient-centred IVF
Gerris, J., & Fauser, B. C. J. M. (2020) · Reproductive BioMedicine Online · doi:10.1016/j.rbmo.2020.10.014 · Cited by 5
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“As part of the swift and disruptive development and use of technology in the context of public health and health care delivery that has characterised the last decades, there have been an increasing number of mHealth tools piloted in clinical contexts and targeting patients with diabetes [7].”
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Vladimirov, I. K., Vladimirov, M., & Tacheva, D. M. (2021) · Open Journal of Obstetrics and Gynecology · doi:10.4236/ojog.2021.119115 · Cited by 4
“Although much is being published regarding telemedicine in the fields of cardiology, diabetics, dermatology, and common practice, not much is being researched in reproductive medicine [6] [7].”
BackgroundChallenge of diabetes mellitus and researchers’ contributions to its control
Odularu, A. T., & Ajibade, P. A. (2021) · Open Chemistry · doi:10.1515/chem-2020-0153 · Cited by 3
“gov/books/NBK459384/ [225] Bashshur RL, Shannon GW, Smith BR, Woodward MA.”
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Mehta, T., John, T., El Zein, A., Faught, V., Nawshin, T., Chilke, T. S., Cohen, C. W., Cherrington, A., & Thirumalai, M. (2025) · JMIR Research Protocols · doi:10.2196/70271 · Cited by 2
“Synchronous human coaching has been shown to be effective in glycemic control for patients with T2DM [70] and has been explored in rural-specific settings as well [71,72].”
IMPACTO DA TELEMEDICINA NA PRESTAÇÃO DE CUIDADOS DE SAÚDE EM ÁREAS RURAIS E REMOTAS
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“Volume - 1 Issue - 1 Introduction Type 2 diabetes mellitus is a metabolic disorder whose main characteristic is high level of sugar (glucose) in blood, caused by insulin resistance [1-2].”
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“This finding is supported by a growing body of evidence demonstrating the positive effects of telemonitoring and tele-screening on glycaemic control, weight management, and physical activity [29–31].”
Metadata
- 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
- Publisher
- SAGE Publications
- Published
- 2015-05
- Volume
- 21
- Issue
- 5
- Pages
- 321-354
- ISSN
- 1530-5627 (ISSN-L)
- 1556-3669
- PMC
- PMC4432488
- 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
- green
- www.ncbi.nlm.nih.gov
- 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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