Evaluation of the clinical outcomes of telehealth for managing diabetes: A PRISMA-compliant meta-analysis
Open accessAbstract
Introduction: The objective of this study was to systematically review the literature and perform a meta-analysis comparing the clinical outcomes of telehealth and usual care in the management of diabetes. Methods: Multiple strategies, including database searches (MEDLINE, PsycINFO, PubMed, EMBASE, and CINAHL), searches of related journals and reference tracking, were employed to widely search publications from January 2005 to December 2017. The change in hemoglobin A1c (HbA1c) levels was assessed as the primary outcome, and changes in blood pressure, blood lipids, body mass index (BMI), and quality of life were examined as secondary outcomes. Results: Nineteen randomized controlled trials (n = 6294 participants) were selected. Telehealth was more effective than usual care in controlling the glycemic index in diabetes patients (weighted mean difference = −0.22%; 95% confidence intervals, −0.28 to −0.15; P < .001). This intervention showed promise in reducing systolic blood pressure levels (P < .001) and diastolic blood pressure levels (P < .001), while no benefits were observed in the control of BMI (P = .79). For total cholesterol and quality of life, telehealth was similar or superior to usual care. Conclusion: Telehealth holds promise for improving the clinical effectiveness of diabetes management. Targeting patients with higher HbA1c (≥9%) levels and delivering more frequent intervention (at least 6 times 1 year) may achieve greater improvement.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Virtual care programs of at least 6 months were more effective in reducing HbA1c levels compared to programs shorter than 6 months or longer than one year.
“These reviews suggest that virtual care programs of at least 6 months were more effective in terms of reducing HbA1c levels compared to programs shorter than 6 months or longer than one year.”
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 [35]
The Discussion says a duration longer than six months could produce larger HbA1c effects, and the Results report that the included interventions lasted 6–12 months. But the paper does not compare those programs with programs longer than one year; its duration-related statement is also tentative, not a finding that 6–12 months was more effective than shorter programs. (LLM, conf=0.86)
Experimental — accuracy not yet measuredAll seven reviews reported a reduction in blood pressure with virtual care.
“all 7 reviews [22, 27, 32, 35, 37, 44, 46] reported reduction in blood pressure.”
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 [35]
All reviews examining diet and physical activity reported that virtual care had a tendency to improve these and other behavioural outcomes.
“all reviews reported that virtual care had a tendency to improve these and other behavioural outcomes.”
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 [35]
The Results (Study characteristics; page unavailable) say telehealth interventions offered advice on healthy diet and physical activity and aimed to improve self-management. The paper assesses clinical outcomes, not changes in diet, physical activity, or other behavioural outcomes; the searched passages do not establish the claimed tendency to improve them. (LLM, conf=0.78)
Experimental — accuracy not yet measuredThe results reflect findings from previous systematic reviews, which have found significant reductions in HbA1c favoring telemedicine.
“The results reflect the findings from previous systematic reviews, which have found significant reductions in HbA1c favoring telemedicine.13,22,283,284”
From The Effectiveness of Telemedicine Solutions for the Management of Type 2 Diabetes: A Systematic Review, Meta-Analysis, and Meta-Regression (2023) · cites this paper as [283]
Faruque et al and Wu et al found a larger effect among studies with a higher baseline HbA1c.
“In line with our findings, Faruque et al and Wu et al found a larger effect among studies with a higher baseline HbA1c.13,283”
From The Effectiveness of Telemedicine Solutions for the Management of Type 2 Diabetes: A Systematic Review, Meta-Analysis, and Meta-Regression (2023) · cites this paper as [283]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Measuring inconsistency in meta-analyses
Higgins, J. P. T., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003) · BMJ · doi:10.1136/bmj.327.7414.557 · Cited by 63,139 · see citing works
Estimating the mean and variance from the median, range, and the size of a sample
Hozo, S. P., Djulbegovic, B., & Hozo, I. (2005) · BMC Medical Research Methodology · doi:10.1186/1471-2288-5-13 · Cited by 9,062 · see citing works
Stratton, I. M. (2000) · BMJ · doi:10.1136/bmj.321.7258.405 · Cited by 9,059 · see citing works
What Is Telemedicine? A Collection of 104 Peer-Reviewed Perspectives and Theoretical Underpinnings
Sood, S., Mbarika, V., Jugoo, S., Dookhy, R., Doarn, C. R., Prakash, N., & Merrell, R. C. (2007) · Telemedicine and e-Health · doi:10.1089/tmj.2006.0073 · Cited by 627 · see citing works
Steventon, A., Bardsley, M., Billings, J., Dixon, J., Doll, H., Hirani, S., Cartwright, M., Rixon, L., Knapp, M., Henderson, C., et al. (2012) · BMJ · doi:10.1136/bmj.e3874 · Cited by 583 · see citing works
Liang, X., Wang, Q., Yang, X., Cao, J., Chen, J., Mo, X., Huang, J., Wang, L., & Gu, D. (2011) · Diabetic Medicine · doi:10.1111/j.1464-5491.2010.03180.x · Cited by 515 · see citing works
Sanders, C., Rogers, A., Bowen, R., Bower, P., Hirani, S., Cartwright, M., Fitzpatrick, R., Knapp, M., Barlow, J., Hendy, J., et al. (2012) · BMC Health Services Research · doi:10.1186/1472-6963-12-220 · Cited by 450 · see citing works
Web-Based Care Management in Patients With Poorly Controlled Diabetes
McMahon, G. T., Gomes, H. E., Hohne, S. H., Hu, T. M.-J., Levine, B. A., & Conlin, P. R. (2005) · Diabetes Care · doi:10.2337/diacare.28.7.1624 · Cited by 319 · see citing works
Online Diabetes Self-Management Program
Lorig, K., Ritter, P. L., Laurent, D. D., Plant, K., Green, M., Jernigan, V. B. B., & Case, S. (2010) · Diabetes Care · doi:10.2337/dc09-2153 · Cited by 316 · see citing works
Shea, S. A., Weinstock, R. S., Starren, J. B., Teresi, J. A., Palmas, W., Field, L., Morin, P. C., Goland, R., Izquierdo, R. E., Wolff, L. T., et al. (2005) · Journal of the American Medical Informatics Association · doi:10.1197/jamia.m1917 · Cited by 309 · see citing works
Arora, S., Peters, A. L., Burner, E., Lam, C. N., & Menchine, M. (2014) · Annals of Emergency Medicine · doi:10.1016/j.annemergmed.2013.10.012 · Cited by 273 · see citing works
Verhoeven, F., van Gemert-Pijnen, L., Dijkstra, K., Nijland, N., Seydel, E., & Steehouder, M. (2007) · Journal of Medical Internet Research · doi:10.2196/jmir.9.5.e37 · Cited by 252 · see citing works
Tang, P. C., Overhage, J. M., Chan, A. S., Brown, N. L., Aghighi, B., Entwistle, M., Hui, S. L., Hyde, S., Klieman, L., Mitchell, C. J., et al. (2012) · Journal of the American Medical Informatics Association · doi:10.1136/amiajnl-2012-001263 · Cited by 240 · see citing works
Home telehealth for diabetes management: a systematic review and meta‐analysis
Polisena, J., Tran, K., Cimon, K., Hutton, B., McGill, S., & Palmer, K. (2009) · Diabetes, Obesity and Metabolism · doi:10.1111/j.1463-1326.2009.01057.x · Cited by 239 · see citing works
Home-based telehealth: a review and meta-analysis
DelliFraine, J. L., & Dansky, K. H. (2008) · Journal of Telemedicine and Telecare · doi:10.1258/jtt.2007.070709 · Cited by 222 · see citing works
Zhai, Y.-K., Zhu, W.-J., Cai, Y.-L., Sun, D.-X., & Zhao, J. (2014) · Medicine · doi:10.1097/md.0000000000000312 · Cited by 221 · see citing works
Self-citationTelemedicine Application in the Care of Diabetes Patients: Systematic Review and Meta-Analysis
Marcolino, M. S., Maia, J. X., Alkmim, M. B. M., Boersma, E., & Ribeiro, A. L. (2013) · PLoS ONE · doi:10.1371/journal.pone.0079246 · Cited by 215 · cited 1× · see citing works
“This parameter reflects the mean glycemia level in the past 2 to 3 months and is strongly associated with complications of diabetes.([15]) Changes in blood pressure, blood lipids, body mass index (BMI), and quality of life, which are important clinical outcomes representing the ultimate goal of treatment,([16]) were t…”
BackgroundTeleHealth Improves Diabetes Self-Management in an Underserved Community
Davis, R. M., Hitch, A. D., Salaam, M. M., Herman, W. H., Zimmer-Galler, I. E., & Mayer-Davis, E. J. (2010) · Diabetes Care · doi:10.2337/dc09-1919 · Cited by 215 · see citing works
Twelve-month outcomes of an Internet-based diabetes self-management support program
Glasgow, R. E., Kurz, D., King, D. K., Dickman, J. M., Faber, A. J., Halterman, E., Woolley, T., Toobert, D. J., Strycker, L. A., Estabrooks, P. A., et al. (2011) · Patient Education and Counseling · doi:10.1016/j.pec.2011.07.024 · Cited by 205 · see citing works
Telehealthcare for long term conditions
McLean, S., Protti, D., & Sheikh, A. (2011) · BMJ · doi:10.1136/bmj.d120 · Cited by 205 · see citing works
Evaluation of a mobile phone telemonitoring system for glycaemic control in patients with diabetes
Istepanian, R. S., Zitouni, K., Harry, D., Moutosammy, N., Sungoor, A., Tang, B., & Earle, K. A. (2009) · Journal of Telemedicine and Telecare · doi:10.1258/jtt.2009.003006 · Cited by 177 · see citing works
Wakefield, B. J., Holman, J. E., Ray, A. L., Scherubel, M., Adams, M. R., Hillis, S. L., & Rosenthal, G. E. (2011) · Telemedicine Journal and e-Health · doi:10.1089/tmj.2010.0176 · Cited by 174 · see citing works
Results of a Successful Telephonic Intervention to Improve Diabetes Control in Urban Adults
Walker, E. A., Shmukler, C., Ullman, R., Blanco, E., Scollan‐Koliopoulos, M., & Cohen, H. W. (2010) · Diabetes Care · doi:10.2337/dc10-1005 · Cited by 164 · see citing works
Kempf, K., Altpeter, B., Berger, J., Reuß, O., Fuchs, M., Schneider, M., Gärtner, B., Niedermeier, K., & Martin, S. (2017) · Diabetes Care · doi:10.2337/dc17-0303 · Cited by 160 · see citing works
Dale, J., Caramlau, I., Sturt, J., Friede, T., & Walker, R. (2009) · Patient Education and Counseling · doi:10.1016/j.pec.2008.09.014 · Cited by 143 · see citing works
Lee, S. W. H., Ooi, L., & Lai, Y. K. (2017) · Frontiers in Pharmacology · doi:10.3389/fphar.2017.00330 · Cited by 117 · see citing works
Wild, S. H., Hanley, J., Lewis, S. C., McKnight, J. A., McCloughan, L. B., Padfield, P. L., Parker, R. A., Paterson, M., Pinnock, H., Sheikh, A., et al. (2016) · PLoS Medicine · doi:10.1371/journal.pmed.1002098 · Cited by 111 · see citing works
Brod, M. I., Skovlund, S. E., & Wittrup-Jensen, K. U. (2006) · Quality of Life Research · doi:10.1007/s11136-005-1624-6 · Cited by 93 · see citing works
Telemedicine consultation for patients with diabetes mellitus: A cluster randomised controlled trial
Sood, A., Watts, S. A., Johnson, J. K., Hirth, S., & Aron, D. C. (2018) · Journal of Telemedicine and Telecare · doi:10.1177/1357633x17704346 · Cited by 86 · see citing works
Bujnowska–Fedak, M. M., Puchała, E., & Steciwko, A. (2011) · Telemedicine Journal and e-Health · doi:10.1089/tmj.2010.0113 · Cited by 84 · see citing works
Telemedicine Influence on the Follow-Up of Type 2 Diabetes Patients
Rodriguez-Idigoras, M. I., Muñoz, J. S., Sánchez-Garrido-Escudero, R., Martinez-Gonzalez, J. L., Castellón, J. L. E., Paniagua-Gómez, I. M., Bernal-López, M. R., Fuentes-Simón, M. V., & Garófano-Serrano, D. (2009) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2008.0114 · Cited by 79 · see citing works
Toward a Theory of Diabetes Self-Care Management
Sousa, V. D., & Zauszniewski, J. A. (2005) · Journal of Theory Construction and Testing · Cited by 67 · see citing works
Managing diabetes care using an integrated regional e-health approach
Harno, K., Kauppinen-Mäkelin, R., & Syrjäläinen, J. (2006) · Journal of Telemedicine and Telecare · doi:10.1258/135763306777978380 · Cited by 61 · see citing works
Telephone Intervention to Improve Diabetes Control
Chamany, S., Walker, E. A., Schechter, C. B., Gonzalez, J. S., Davis, N. J., Ortega, F. M., Carrasco, J., Basch, C. E., & Silver, L. D. (2015) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2015.04.016 · Cited by 55 · see citing works
Warren, R., Carlisle, K., Mihala, G., & Scuffham, P. A. (2018) · Journal of Telemedicine and Telecare · doi:10.1177/1357633x17723943 · Cited by 54 · see citing works
Cho, J. H., Kim, H.-S., Yoo, S. H., Jung, C. H., Lee, W. J., Park, C. Y., Yang, H. K., Park, J. Y., Park, S. W., & Yoon, K. H. (2017) · Journal of Telemedicine and Telecare · doi:10.1177/1357633x16657500 · Cited by 45 · see citing works
Leichter, S. B., Bowman, K., Adkins, R. A., & Jelsovsky, Z. (2013) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2012.0323 · Cited by 32 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- [14]Shuster JJ Julian PT Review: Cochrane handbook for systematic reviews for interventions, Version 5.1.0, published 3/2011. Higgins and Sally Green. Chichester, UK: John Wiley & Sons, Ltd; 2011 126– 30. Vol 2.
Cited by
Sorted by citations
Timpel, P., Oswald, S., Schwarz, P. E. H., & Harst, L. (2020) · Journal of Medical Internet Research · doi:10.2196/16791 · Cited by 243 · see citing works
Adepoju, O. E., Chae, M., Ojinnaka, C. O., Shetty, S., & Angelocci, T. (2022) · Journal of General Internal Medicine · doi:10.1007/s11606-021-07304-4 · Cited by 131 · see citing works
Eberle, C., & Stichling, S. (2021) · Journal of Medical Internet Research · doi:10.2196/23244 · Cited by 119 · see citing works
Efficacy of telemedicine on glycaemic control in patients with type 2 diabetes: A meta-analysis
De Groot, J., Wu, D., Flynn, D., Robertson, D., Grant, G., & Sun, J. (2021) · World Journal of Diabetes · doi:10.4239/wjd.v12.i2.170 · Cited by 77 · see citing works
Hangaard, S., Laursen, S. H., Andersen, J. D., Kronborg, T., Vestergaard, P., Hejlesen, O., & Udsen, F. W. (2023) · Journal of Diabetes Science and Technology · doi:10.1177/19322968211064633 · Cited by 55 · see citing works
Six Digital Health Technologies That Will Transform Diabetes
Klonoff, A. N., Lee, W.-A. (., Xu, N. Y., Nguyen, K. T., DuBord, A., & Kerr, D. (2023) · Journal of Diabetes Science and Technology · doi:10.1177/19322968211043498 · Cited by 44 · see citing works
Greenwood, D. A., Litchman, M. L., Isaacs, D., Blanchette, J. E., Dickinson, J. K., Hughes, A., Colicchio, V. D., Ye, J., Yehl, K., Todd, A., et al. (2022) · Journal of Diabetes Science and Technology · doi:10.1177/19322968211036430 · Cited by 31 · see citing works
Pekmezaris, R., Williams, M. S., Pascarelli, B., Finuf, K. D., Harris, Y. T., Myers, A. K., Taylor, T., Kline, M., Patel, V. H., Murray, L. M., et al. (2020) · BMC Medical Informatics and Decision Making · doi:10.1186/s12911-020-01346-0 · Cited by 26 · see citing works
Ravi, S., Meyerowitz-Katz, G., Yung, C., Ayre, J., McCaffery, K., Maberly, G., & Bonner, C. (2025) · BMC Health Services Research · doi:10.1186/s12913-025-12496-0 · Cited by 19 · see citing works
- Authors
- Wu, C., Wu, Z., Yang, L., Zhu, W., Zhang, M., Zhu, Q., Chen, X., & Pan, Y.
- Affiliations
- Women's Hospital (US)
- Second Affiliated Hospital of Zhejiang University (CN)
- Corresponding author
- Pan, Yongmiao
- Venue
- Medicine
- Published
- 2018-10
- Volume
- 97
- Issue
- 43
- Pages
- e12962
- ISSN
- 0025-7974 (ISSN-L)
- 1536-5964
- PMC
- PMC6221638
- OpenAlex
- W2898519972
- Cited by
- 86
- References
- 37
- Citations by year
- 2026: 3 · 2025: 9 · 2024: 11 · 2023: 10 · 2022: 16 · 2021: 18 · 2020: 15 · 2019: 4
- FWCI
- 1.68
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Medicine (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- 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, diabetes management, glycemic control, HbA1c, blood pressure, serum lipids, body mass index, quality of life, usual care comparison, remote patient monitoring
- MeSH terms
- Blood Glucose, Cholesterol, Diabetes Mellitus, Glycated Hemoglobin, Humans, Quality of Life, Body Mass Index, Randomized Controlled Trials as Topic, Outcome Assessment, Health Care, Telemedicine
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
