TeleHealth Improves Diabetes Self-Management in an Underserved Community
Open accessAbstract
OBJECTIVE: To conduct a 1-year randomized clinical trial to evaluate a remote comprehensive diabetes self-management education (DSME) intervention, Diabetes TeleCare, administered by a dietitian and nurse/certified diabetes educator (CDE) in the setting of a federally qualified health center (FQHC) in rural South Carolina. RESEARCH DESIGN AND METHODS: Participants were recruited from three member health centers of an FQHC and were randomized to either Diabetes TeleCare, a 12-month, 13-session curriculum delivered using telehealth strategies, or usual care. RESULTS: Mixed linear regression model results for repeated measures showed a significant reduction in glycated hemoglobin (GHb) in the Diabetes TeleCare group from baseline to 6 and 12 months (9.4 ± 0.3, 8.3 ± 0.3, and 8.2 ± 0.4, respectively) compared with usual care (8.8 ± 0.3, 8.6 ± 0.3, and 8.6 ± 0.3, respectively). LDL cholesterol was reduced at 12 months in the Diabetes TeleCare group compared with usual care. Although not part of the original study design, GHb was reduced from baseline to 12 and 24 months in the Diabetes TeleCare group (9.2 ± 0.4, 7.4 ± 0.5, and 7.6 ± 0.5, respectively) compared with usual care (8.7 ± 0.4, 8.1 ± 0.4, and 8.1 ± 0.5, respectively) in a post hoc analysis of a subset of the randomized sample who completed a 24-month follow-up visit. CONCLUSIONS: Telehealth effectively created access to successfully conduct a 1-year remote DSME by a nurse CDE and dietitian that improved metabolic control and reduced cardiovascular risk in an ethnically diverse and rural population.
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Of 52 included RCTs, 11 (21%) assessed the effects of 9 different DHI strategy combinations on BMI levels in patients with T2DM.
“Of 52 included RCTs, 11 (21%) RCTs [60,66,70,72-74,78,84,85,97,98] assessed the effects of 9 different DHI strategy combinations on BMI levels in patients with T2DM.”
From Assessing the Effectiveness of Digital Health Behavior Strategies on Type 2 Diabetes Management: Systematic Review and Network Meta-Analysis (2025) · cites this paper as [66]
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- Authors
- Davis, R. M., Hitch, A. D., Salaam, M. M., Herman, W. H., Zimmer-Galler, I. E., & Mayer-Davis, E. J.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- University of South Carolina (US)
- University of Michigan (US)
- Johns Hopkins University (US)
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina.
- Corresponding author
- Davis, Richard M.
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2010-05-18
- Volume
- 33
- Issue
- 8
- Pages
- 1712-1717
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC2909047
- OpenAlex
- W2141936258
- Cited by
- 215
- References
- 2
- Citations by year
- 2026: 8 · 2025: 10 · 2024: 15 · 2023: 17 · 2022: 16 · 2021: 18 · 2020: 15 · 2019: 6 · 2018: 21 · 2017: 16 · 2016: 12 · 2015: 22 · 2014: 10 · 2013: 22 · 2012: 4
- FWCI
- 7.02
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- Diabetes Care (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Institute of Diabetes and Digestive and Kidney Diseases (R18DK067312)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- telemedicine, diabetes self-management education, HbA1c, glycemic control, LDL cholesterol, cardiovascular risk, certified diabetes educator, dietitians, federally qualified health centers, remote intervention
- MeSH terms
- Aged, Diabetes Mellitus, Female, Health Personnel, Humans, Male, Middle Aged, Patient Education as Topic, Rural Population, Self Care, South Carolina, Telemedicine
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