Video consultations as add-on to standard care among patients with type 2 diabetes not responding to standard regimens: a randomized controlled trial
Abstract
Objective: To examine whether video consultations preceded by measurements of blood glucose, weight and blood pressure as add-on to standard care could contribute to achieving and maintaining good diabetes control among patients with poorly regulated type 2 diabetes (T2D). Design: Randomized controlled trial. Methods: 165 patients with T2D were randomized 1:1 to telemedicine intervention as add-on to clinic-based care or control (clinic-based care). The intervention consisted of monthly video conferences with a nurse via a tablet computer and lasted for 32 weeks. Regularly self-monitored measurements of blood sugar, blood pressure and weight were uploaded and visible to patient and nurse. Both groups were followed up six months after the end of the intervention period. Primary endpoint: HbA1c after eight months. Results: Video conferences preceded by uploads of measurements as add-on to clinic-based care led to a significant reduction of HbA1c compared to that in standard care (0.69% vs 0.18%, P = 0.022). However, at six-month follow-up, the inter-group difference in HbA1c-reduction was no longer significant. Non-completers had higher HbA1c levels at baseline and a lower degree of education. Conclusion: Video consultations preceded by uploading relevant measurements can lead to clinically and statistically significant improvements in glycemic control among patients who have not responded to standard regimens. However, continuing effort and attention are essential as the effect does not persist when intervention ends. Furthermore, future studies should focus on differentiation as the most vulnerable patients are at greater risk of non-adherence.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
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?
In two studies reporting quality of life, both found no difference between groups.
“Two studies reported on quality of life.16 18 Both studies found no difference between groups.”
From Effectiveness of synchronous teleconsultation for patients with type 2 diabetes mellitus: a systematic review and meta-analysis (2023) · cites this paper as [18]
Cites
Long-term effects of intensive glucose lowering on cardiovascular outcomes
The ACCORD Study Group (2011) · New England Journal of Medicine · doi:10.1056/nejmoa1006524 · Cited by 1,035 · 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
Connolly, V. M., Unwin, N. C., Sherriff, P., Bilous, R., & Kelly, W. (2000) · Journal of Epidemiology & Community Health · doi:10.1136/jech.54.3.173 · Cited by 517 · see citing works
Ethnicity, Obesity, and Risk of Type 2 Diabetes in Women
Shai, I., Jiang, R., Manson, J. E., Stampfer, M. J., Willett, W. C., Colditz, G. A., & Hu, F. B. (2006) · Diabetes Care · doi:10.2337/dc06-0057 · Cited by 479 · 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
Shea, S., Weinstock, R. S., Teresi, J. A., Palmas, W., Starren, J. B., Cimino, J. J., Lai, A. M., Field, L., Morin, P. C., Goland, R., et al. (2009) · Journal of the American Medical Informatics Association · doi:10.1197/jamia.m3157 · Cited by 375 · see citing works
Nielsen, S. S., & Krasnik, A. (2010) · International Journal of Public Health · doi:10.1007/s00038-010-0145-4 · Cited by 314 · 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
Holmen, H., Torbjørnsen, A., Wahl, A. K., Jenum, A. K., Småstuen, M. C., Årsand, E., & Ribu, L. (2014) · JMIR mHealth and uHealth · doi:10.2196/mhealth.3882 · Cited by 294 · see citing works
Asynchronous and synchronous teleconsultation for diabetes care: A systematic literature review
Verhoeven, F., Tanja-Dijkstra, K., Nijland, N., Eysenbach, G., & van Gemert-Pijnen, L. (2010) · Journal of Diabetes Science and Technology · doi:10.1177/193229681000400323 · Cited by 247 · 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
Philis‐Tsimikas, A., Fortmann, A., Ocana, L. L., Walker, C., & Gallo, L. C. (2011) · Diabetes Care · doi:10.2337/dc10-2081 · Cited by 214 · see citing works
Socioeconomic inequalities in diabetes mellitus across Europe at the beginning of the 21st century
Espelt, A., Borrell, C., Roskam, A.-J. R., Rodríguez‐Sanz, M., Stirbu, I., Dalmau-Bueno, A., Regidor, E., Bopp, M., Martikainen, P., Leinsalu, M., et al. (2008) · Diabetologia · doi:10.1007/s00125-008-1146-1 · Cited by 208 · see citing works
Improvement in Diabetes Care of Underinsured Patients Enrolled in Project Dulce
Philis‐Tsimikas, A., Walker, C., Rivard, L., Talavera, G. A., Reimann, J. O. F., Salmon, M., & Araujo, R. A. (2004) · Diabetes Care · doi:10.2337/diacare.27.1.110 · Cited by 208 · see citing works
A Comparison of Diabetes Education Administered Through Telemedicine Versus in Person
Izquierdo, R. E., Knudson, P. E., Meyer, S., Kearns, J. W., Ploutz-Snyder, R. J., & Weinstock, R. S. (2003) · Diabetes Care · doi:10.2337/diacare.26.4.1002 · Cited by 202 · see citing works
Sacerdote, C., Ricceri, F., Rolandsson, O., Baldi, I., Chirlaque, M., Feskens, E. J. M., Bendinelli, B., Ardanáz, E., Arriola, L., Balkau, B., et al. (2012) · International Journal of Epidemiology · doi:10.1093/ije/dys091 · Cited by 199 · see citing works
Grintsova, O., Maier, W., & Mielck, A. (2014) · International Journal for Equity in Health · doi:10.1186/1475-9276-13-43 · Cited by 191 · 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
Glycemic Control and Health Disparities in Older Ethnically Diverse Underserved Adults With Diabetes
Weinstock, R. S., Teresi, J. A., Goland, R., Izquierdo, R. E., Palmas, W., Eimicke, J. P., Ebner, S. A., & Shea, S. A. (2011) · Diabetes Care · doi:10.2337/dc10-1346 · Cited by 155 · see citing works
Telemedicine Improved Diabetic Management
Whitlock, W. L., Brown, A., Moore, K., Pavliscsak, H. H., Dingbaum, A., Lacefield, D., Buker, K. L., & Xenakis, S. (2000) · Military Medicine · doi:10.1093/milmed/165.8.579 · Cited by 133 · see citing works
Jenum, A. K., Diep, L. M., Holmboe‐Ottesen, G., Holme, I., Kumar, B., & Birkeland, K. I. (2012) · BMC Public Health · doi:10.1186/1471-2458-12-150 · Cited by 99 · see citing works
Nicolucci, A., Cercone, S., Chiriatti, A., Muscas, F., Gensini, G., & on behalf of the REMOTE Study Group (2015) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2014.0355 · Cited by 69 · see citing works
Wakefield, B. J., Koopman, R. J., Keplinger, L. E., Bomar, M., Bernt, B., Johanning, J. L., Kruse, R. L., Davis, J. W., Wakefield, D. S., & Mehr, D. R. (2014) · Telemedicine Journal and e-Health · doi:10.1089/tmj.2013.0151 · Cited by 65 · see citing works
Anderson, D. R., Christison-Lagay, J., Villagra, V., Liu, H., & Dziura, J. (2010) · Journal of General Internal Medicine · doi:10.1007/s11606-010-1419-5 · Cited by 64 · see citing works
Chatterji, P., Joo, H., & Lahiri, K. (2011) · Diabetes Care · doi:10.2337/dc11-1405 · Cited by 63 · see citing works
Socio-economic differences in the prevalence of diabetes in Italy: The population-based Turin study
Gnavi, R., Karaghiosoff, L., Costa, G., et al. (2008) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2007.11.004 · Cited by 63 · see citing works
Rasmussen, O. W., Lauszus, F., & Loekke, M. (2016) · Journal of Telemedicine and Telecare · doi:10.1177/1357633x15608984 · Cited by 59 · see citing works
Long-term effect of home telehealth services on preventable hospitalization use
Jia, H., Chuang, H., Wu, S. S., Wang, X., & Chumbler, N. R. (2009) · The Journal of Rehabilitation Research and Development · doi:10.1682/jrrd.2008.09.0133 · Cited by 51 · see citing works
Shea, S., Kothari, D., Teresi, J. A., Kong, J., Eimicke, J. P., Lantigua, R., Palmas, W., & Weinstock, R. S. (2013) · American Journal of Public Health · doi:10.2105/ajph.2012.300909 · Cited by 46 · see citing works
Dinesen, C., Nielsen, S. S., Mortensen, L. H., et al. (2011) · International Journal of Public Health · doi:10.1007/s00038-011-0264-6 · Cited by 45 · see citing works
(2014) · Europe PMC (PubMed Central) · Cited by 40 · see citing works
Pressman, A. R., Kinoshita, L., Kirk, S., Barbosa, G. M., Chou, C., & Minkoff, J. R. (2014) · Telemedicine Journal and e-Health · doi:10.1089/tmj.2013.0157 · Cited by 34 · see citing works
Telemedicine for clinical management of diabetes – a process analysis of video consultations
Fatehi, F., Gray, L., & Russell, A. (2013) · Journal of Telemedicine and Telecare · doi:10.1177/1357633x13506524 · Cited by 29 · see citing works
Effects of telemedicine in the treatment of patients with type 2 diabetes--a study protocol.
Hansen, C. R., Perrild, H., Koefoed, B. G., et al. (2013) · PubMed · Cited by 2 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Greenhalgh, T., Shaw, S., Wherton, J., Vijayaraghavan, S., Morris, J., Bhattacharya, S., Hanson, P., Campbell-Richards, D., Ramoutar, S., Collard, A., et al. (2018) · Journal of Medical Internet Research · doi:10.2196/jmir.9897 · Cited by 371 · see citing works
Grunberger, G., Sherr, J., Allende, M., Blevins, T., Bode, B., Handelsman, Y., Hellman, R., Lajara, R., Roberts, V. L., Rodbard, D., et al. (2021) · Endocrine Practice · doi:10.1016/j.eprac.2021.04.008 · Cited by 288 · see citing works
Liu, K., Xie, Z., & Or, C. K. (2020) · JMIR mHealth and uHealth · doi:10.2196/15779 · Cited by 181 · see citing works
Wherton, J., Shaw, S., Papoutsi, C., Seuren, L., & Greenhalgh, T. (2020) · BMJ Leader · doi:10.1136/leader-2020-000262 · Cited by 154 · 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
Alanzi, T. M. (2023) · Journal of Multidisciplinary Healthcare · doi:10.2147/jmdh.s419847 · Cited by 58 · see citing works
Eberle, C., & Stichling, S. (2021) · Journal of Medical Internet Research · doi:10.2196/23252 · Cited by 38 · see citing works
Zhang, J., Ji, X., Xie, J., Lin, K., Yao, M., & Chi, C. (2023) · BMJ Open Diabetes Research & Care · doi:10.1136/bmjdrc-2022-003180 · Cited by 22 · see citing works
Greenhalgh, T., Shaw, S., Wherton, J., Vijayaraghavan, S., Morris, J., Bhattacharya, S., Hanson, P., Campbell-Richards, D., Ramoutar, S., Collard, A., et al. (2018) · doi:10.2196/preprints.9897 · Cited by 371 · see citing works
- Authors
- Hansen, C. R., Perrild, H., Koefoed, B. G., & Zander, M.
- Affiliations
- Bispebjerg Hospital (DK)
- 2Healthcare Centre NørrebroCopenhagen NV, Denmark
- Corresponding author
- Hansen, Caroline Raun
- Venue
- European Journal of Endocrinology
- Publisher
- Oxford University Press (OUP)
- Published
- 2017-06
- Volume
- 176
- Issue
- 6
- Pages
- 727-736
- ISSN
- 0804-4643 (ISSN-L)
- 1479-683X
- OpenAlex
- W2602402691
- Cited by
- 53
- References
- 34
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 3 · 2023: 7 · 2022: 13 · 2021: 9 · 2020: 10 · 2019: 3 · 2018: 6
- FWCI
- 4.87
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Endocrinology (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 › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- type 2 diabetes, video consultation, telemedicine, glycemic control, HbA1c, uncontrolled diabetes, nurse-led care, self-monitoring of blood glucose, intervention adherence, digital health
- MeSH terms
- Aged, Blood Pressure, Body Weight, Combined Modality Therapy, Cross-Sectional Studies, Denmark, Diabetes Mellitus, Type 2, Diabetic Angiopathies, Female, Follow-Up Studies, Glycated Hemoglobin, Humans, Hyperglycemia, Hypertension, Male, Middle Aged, Patient Compliance, Self Care, Blood Glucose Self-Monitoring, Body Mass Index, Videoconferencing, Overweight, Telenursing
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
