Effect of Telemetric Interventions on Glycated Hemoglobin A1c and Management of Type 2 Diabetes Mellitus: Systematic Meta-Review
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Abstract
Background: Diabetes mellitus is a chronic burden, with a prevalence that is increasing worldwide. Telemetric interventions have attracted great interest and may provide effective new therapeutic approaches for improving type 2 diabetes mellitus (T2DM) care. Objective: The objective of this study was to analyze the clinical effectiveness of telemetric interventions on glycated hemoglobin A1c (HbA1c) specifically and T2DM management generally in a systematic meta-review. Methods: A systematic literature search was performed in PubMed, CINAHL, Cochrane Library, Web of Science Core Collection, and EMBASE databases from January 2008 to April 2020. Studies that addressed HbA1c, blood pressure, fasting blood glucose, BMI, diabetes-related and health-related quality of life, cost-effectiveness, time savings, and the clinical effectiveness of telemetric interventions were analyzed. In total, 73 randomized controlled trials (RCTs), 10 systematic reviews/meta-analyses, 9 qualitative studies, 2 cohort studies, 2 nonrandomized controlled studies, 2 observational studies, and 1 noncontrolled intervention study were analyzed. Results: Overall, 1647 citations were identified. After careful screening, 99 studies (n=15,939 patients; n=82,436 patient cases) were selected by two independent reviewers for inclusion in the review. Telemetric interventions were categorized according to communication channels to health care providers: (1) “real-time video” interventions, (2) “real-time audio” interventions, (3) “asynchronous” interventions, and (4) “combined” interventions. To analyze changes in HbA1c, suitable RCTs were pooled and the average was determined. An HbA1c decrease of –1.15% (95% CI –1.84% to –0.45%), yielding an HbA1c value of 6.95% (SD 0.495), was shown in studies using 6-month “real-time video” interventions. Conclusions: Telemetric interventions clearly improve HbA1c values in both the short term and the long term and contribute to the effective management of T2DM. More studies need to be done in greater detail.
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Two of three reviews indicated a positive effect of cost savings due to less travel, wait times and increased access to services.
“Among 3 reviews [25, 32, 34], 2 have indicated a positive effect of cost savings due to less travel, wait times and increased access to services.”
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 [32]
The Results sections on combined interventions report lower costs and money saved on physical visits; the real-time video section reports shorter travel and waiting times. The paper does not establish that reduced waiting times or increased access to services caused cost savings, and it cannot substantiate the citing sentence’s count of two out of three reviews. (LLM, conf=0.83)
Experimental — accuracy not yet measuredDigital technology has the potential to support people living with T2DM in achieving their glycemic goals.
“It has been suggested that digital technology has the potential to support people living with T2DM in their efforts toward achieving their glycemic goals [11,12].”
From Digital Interventions for Self-Management of Type 2 Diabetes Mellitus: Systematic Literature Review and Meta-Analysis (2024) · cites this paper as [12]
Three reviews reported that video conferencing was effective in improving HbA1c levels over periods ranging from 3 to 12 months.
“Three reviews [32, 34, 44] reported that video conferencing was effective in improving HbA1c levels over periods ranging from 3–12 months.”
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 [32]
All 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 [32]
Two reviews reported a reduction in fasting blood glucose with virtual care.
“out of which 2 reviews reported reduction in fasting blood glucose [32, 46]”
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 [32]
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- Authors
- Eberle, C., & Stichling, S.
- Affiliations
- Fulda University of Applied Sciences (DE)
- Corresponding author
- Eberle, Claudia
- Venue
- Journal of Medical Internet Research
- Publisher
- JMIR Publications Inc.
- Published
- 2021-02-17
- Volume
- 23
- Issue
- 2
- Pages
- e23252
- ISSN
- 1438-8871 (ISSN-L)
- PMC
- PMC7929744
- OpenAlex
- W3131520533
- Cited by
- 38
- References
- 80
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 3 · 2023: 11 · 2022: 9 · 2021: 4
- FWCI
- 1.00
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Journal of Medical Internet Research (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Publication Server of Goethe University Frankfurt am Main (Goethe University Frankfurt) (cc-by)
- 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, type 2 diabetes, HbA1c, diabetes management, blood pressure, fasting blood glucose, body mass index, quality of life, cost-effectiveness, time savings
- MeSH terms
- Diabetes Mellitus, Type 2, Glycated Hemoglobin, Humans, Quality of Life, Telemetry, 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 ›
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