Interactive Video Telehealth Models to Improve Access to Diabetes Specialty Care and Education in the Rural Setting: A Systematic Review
Open accessAbstract
The burden of diabetes is complex and growing in epidemic proportions. According to the American Diabetes Association (ADA), ∼29.1 million Americans (9.3% of the population) were diagnosed with diabetes as of 2015, and >1 million new cases of diabetes are diagnosed in people ≥20 years of age in the United States each year (1). Diabetes is also on the rise globally. The International Diabetes Federation has predicted that the number of people with diabetes worldwide will rise from the present 415 million to 642 million in 2040 (2). Diabetes is the seventh leading cause of death in the United States and kills more people every year than AIDS and breast cancer combined (1). Patients with diabetes often have comorbid conditions of hypertension, dyslipidemia, retinopathy, neuropathy, kidney failure, lower limb amputations, and cardiovascular disease (3). Alarmingly, in the past decade, research has shown an increased risk for pancreatic, liver, colorectal, endometrial, and breast cancer among people living with diabetes (4). Although additional studies are needed to determine the causes of this risk, cancer screening is a necessary standard of diabetes care. Increased diabetes incidence in the United States is attributed to an aging population, increased diabetes risk among expanding minority groups (i.e., non-Hispanic blacks, Asians, Hawaiians/Pacific Islanders, and Native Americans/Alaska Natives), sedentary lifestyle, and high rates of obesity (5). In 2012, the ADA reported that diabetes accounted for $245 billion in public costs, including $176 billion in direct costs and $69 billion in indirect costs (i.e., disability, work loss, and premature mortality). In the absence of an improved diabetes management strategy, escalating costs will create an enormous economic burden for the already strained U.S. health care system. The prevalence of diabetes is 17% higher in adults living in rural areas than in the population as a whole (6). Rural populations …
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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 [34]
The Results > Cost-Benefit Review reports that three of four cost-analysis studies had positive cost-benefit findings, including savings from avoided travel. The Discussion > Benefits of Telehealth in Rural Areas also describes improved access and lower travel costs. Our copy does not establish reduced wait times, and its three-of-four figure does not substantiate the citing sentence’s two-of-three count. (LLM, conf=0.86)
Experimental — accuracy not yet measuredOne review concluded that interactive video telehealth technologies might be effective in enhancing access to quality care, patient empowerment and self-care management.
“One review concluded that interactive video telehealth technologies might be effective in enhancing access to quality care, contribute to patient empowerment and self-care management [34].”
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 [34]
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 [34]
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- Authors
- McLendon, S. F.
- Affiliations
- Meadows Regional Medical Center (US)
- Corresponding author
- McLendon, Susan Florence
- Venue
- Diabetes Spectrum
- Publisher
- American Diabetes Association
- Published
- 2017-05-01
- Volume
- 30
- Issue
- 2
- Pages
- 124-136
- ISSN
- 1040-9165 (ISSN-L)
- 1944-7353
- PMC
- PMC5439356
- OpenAlex
- W2606748064
- Cited by
- 57
- References
- 29
- Citations by year
- 2026: 4 · 2025: 12 · 2024: 6 · 2023: 8 · 2022: 8 · 2021: 10 · 2020: 4 · 2019: 4 · 2018: 1
- FWCI
- 0.40
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes Spectrum (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- 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
- diabetes management, diabetes education, rural health, access to specialist care, telemedicine, diabetes prevalence, diabetes comorbidity, cancer screening, health care costs
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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