Does nutritional counseling in telemedicine improve treatment outcomes for diabetes? A systematic review and meta-analysis of results from 92 studies
Abstract
Background: A growing number of studies and reviews have documented the impact of telemedicine on diabetes management. However, no meta-analysis has assessed whether including nutritional counseling as part of a telemedicine program has a significant impact on diabetes outcomes or what kind of nutritional counseling is most effective. Methods: Original research articles examining the effect of telemedicine interventions on HbA1c levels in patients with Type 1 or Type 2 diabetes were included in this study. A literature search was performed and 92 studies were retained for analysis. We examined stratified results by differentiating interventions using no nutritional counseling from those that used nutritional counseling. We further compared between nutritional counseling administered via short message systems (SMS) such as email and text messages, and nutritional counseling administered via telephone or videoconference. Results: Telemedicine programs that include a nutritional component show similar effect in diabetes management as those programs that do not. Furthermore, subgroup analysis reveals that nutritional intervention via SMS such as email and text messages is at least as equally effective in reducing HbA1c when compared to personal nutritional counseling with a practitioner over videoconference or telephone. Conclusion: The inclusion of nutritional counseling as part of a telemedicine program does not make a significant difference to diabetes outcomes. Incorporating nutritional counseling into telemedicine programs via SMS is at least as effective as counseling via telephone or videoconference.
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Three reviews reported that text-messaging or SMS feedback was equally effective in improving HbA1c compared to a teleconference or telephone appointment with healthcare professionals.
“3 reviews [28, 31, 43] reported that interventions as simple as text-messaging or SMS feedback were equally effective in improving HbA1c, compared to a teleconference or telephone appointment with healthcare professionals.”
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 [28]
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ResultInfluentialDietary Recommendations for Persons with Type 2 Diabetes Mellitus
Skurk, T., Bosy‐Westphal, A., Grünerbel, A., Kabisch, S., Keuthage, W., Kronsbein, P., Müssig, K., Nussbaumer, H., Pfeiffer, A. F. H., Simon, M., et al. (2024) · Experimental and Clinical Endocrinology & Diabetes · doi:10.1055/a-2166-6772 · Cited by 5 · see citing works
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“One meta-analysis found no significant differences in diabetes outcomes [28], but the effectiveness of NG, including telemedicine, requires further investigation.”
BackgroundEmpfehlungen zur Ernährung von Personen mit Typ-2-Diabetes mellitus
Skurk, T., Bosy‐Westphal, A., Grünerbel, A., Kabisch, S., Keuthage, W., Kronsbein, P., Müssig, K., Nussbaumer, H., Pfeiffer, A. F. H., Simon, M., et al. (2025) · Die Diabetologie · doi:10.1007/s11428-025-01341-x
“DerErnährungstherapieplanmussauch mit der gesamten Managementstrategie einschließlich der Verwendung von Medi-kamenten, körperlicher Aktivität usw. ko-ordiniertundlaufendabgestimmtwerden.”
InfluentialLa telesalud como estrategia de atención primaria en la diabetes mellitus tipo 2 en Colombia
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“La diabetes es una enfermedad de naturaleza compleja, que requiere del acompañamiento continuo al paciente para la adecuada adherencia a los planes de manejo farmacológico y no farmacológico, destacando los cambios en el estilo de vida, especialmente en la actividad física, la alimentación y el adecuado autocontrol (3…”
BackgroundInfluentialNutritional Recommendations for the Prevention of Type 2 Diabetes Mellitus
Skurk, T., Grünerbel, A., Hummel, S., Kabisch, S., Keuthage, W., Kleinridders, A., Müssig, K., Nussbaumer, H., Rubin, D., Simon, M.-C., et al. (2026) · Experimental and clinical endocrinology & diabetes · doi:10.1055/a-2766-3137
Empfehlungen zur Ernährungsprävention des Typ-2-Diabetes mellitus
Skurk, T., Grünerbel, A., Hummel, S., Kabisch, S., Keuthage, W., Kleinridders, A., Müssig, K., Nussbaumer, H., Rubin, D., Simon, M.-C., et al. (2025) · Diabetologie und Stoffwechsel · doi:10.1007/s11428-026-01473-8
“Um zu untersuchen, inwieweit eine pflanzliche Ernährung auch bei T2Dm vorteilhaft sein kann, wurden von Satija et al. [38]”
Empfehlungen zur Ernährungsprävention des Typ-2-Diabetes mellitus
Skurk, T., Grünerbel, A., Hummel, S., der DDG, A. D. &. S., Kabisch, S., Keuthage, W., Müssig, K., Nussbaumer, H., Rubin, D., Simon, M., et al. (2025) · Die Diabetologie · doi:10.1007/s11428-025-01340-y
Empfehlungen zur Ernährungsprävention des Typ‑2‑Diabetes mellitus
Skurk, T., Grünerbel, A., Hummel, S., der DDG, D. A. D. &. S., Kabisch, S., Keuthage, W., Müssig, K., Nussbaumer, H., Rubin, D., Simon, M., et al. (2024) · Die Diabetologie · doi:10.1007/s11428-024-01173-1
“Jedoch unterschieden sich die Gruppen insofern, als ein Diabetescoach nur den Patienten der Interventionsgruppe zur Verfügung stand [45].”
- Authors
- Su, D., McBride, C., Zhou, J., & Kelley, M. S.
- Affiliations
- University of Nebraska Medical Center (US)
- Brigham Young University (US)
- University of Nebraska–Lincoln (US)
- Corresponding author
- McBride, Chelsea
- Venue
- Journal of Telemedicine and Telecare
- Publisher
- SAGE Publications
- Published
- 2016-07-10
- Volume
- 22
- Issue
- 6
- Pages
- 333-347
- ISSN
- 1357-633X (ISSN-L)
- 1758-1109
- OpenAlex
- W1862131840
- Cited by
- 39
- References
- 0
- Citations by year
- 2026: 1 · 2025: 6 · 2024: 7 · 2023: 5 · 2022: 6 · 2021: 8 · 2020: 1 · 2017: 4
- FWCI
- 0.19
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Telemedicine and Telecare (publishedVersion)
- 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 › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- telemedicine, nutrition counseling, diabetes management, HbA1c, glycemic control, type 1 diabetes, type 2 diabetes, text messaging, email, telephone counseling
- MeSH terms
- Counseling, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Glycated Hemoglobin, Humans, Randomized Controlled Trials as Topic, Treatment Outcome, Telemedicine, Nutritional Sciences
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