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Cited by 55Telemedicine and Telehealth ImplementationDiabetes Management and EducationMobile Health and mHealth Applications

Impact of Telehealth Care among Adults Living with Type 2 Diabetes in Primary Care: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

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Robson, Natalie, Hosseinzadeh, Hassan·2021·International Journal of Environmental Research and Public Health
DOI 10.3390/ijerph182212171PMC PMC8622760
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Abstract

Primary health care physicians are increasingly offering telehealth services to patients not only for its cost and time saving advantages but for the additional benefits telehealth can provide for patients with type 2 diabetes (T2D) such as improved self-management behaviours. To support the development of telehealth based T2D clinical care models in primary health care settings, a narrative synthesis and meta-analysis of randomised controlled trial studies was completed for 29 studies that evaluated the effect of one or more types of telehealth interventions on HbA1c levels compared to usual care alone. Results from the random effects meta-analysis demonstrated that telehealth interventions had a stronger influence on HbA1c compared to usual care with a mean difference in HbA1c \% −0.18 (CI −0.35, −0.01), p = 0.04. Results from the subgroup meta-analysis demonstrated that telehealth interventions, when grouped by type of telemonitoring (mHealth and telephone communication), all have a stronger effect on lowering HbA1c levels; however, none of these findings were significant. Key findings from this review demonstrate that telehealth interventions that address T2D self-management behaviours and have higher levels of health care provider engagement, have greater effects on lowering HbA1c levels compared to usual care alone.

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Crossref · 10.3390/ijerph182212171

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  • Three reviews reported that individualised feedback, either through automated algorithms or health care professionals, improved HbA1c control.

    “A further 3 reviews reported that individualised feedback, either through automated algorithms or health care professionals, improved HbA1c control [24, 38, 48].”

    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 [48]

    The Discussion (page not available) reports that telemonitoring interventions with significant HbA1c changes incorporated personalised feedback, and that four mHealth studies with significant reductions shared this feature. It does not establish that the feedback caused the improvement or specify that it was delivered through automated algorithms; the authors frame the broader conclusion as a suggestion. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • Findings from this umbrella review align with recent evidence that virtual care interventions, whether short term or long term, are clearly effective in improving the management of type 2 diabetes.

    “Findings from this umbrella review align with recent evidence that virtual care interventions, whether short term or long term, are clearly effective in improving the management of type 2 diabetes [48].”

    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 [48]

    The Results (section 3.8; page unavailable) report a significant overall improvement in HbA1c with telehealth, supporting the claim that virtual care can help manage type 2 diabetes. But the paper does not establish effectiveness separately for short- and long-term interventions: section 3.1 lists their durations without comparing outcomes by duration, and the Conclusions call for longitudinal studies to understand long-term effects. Calling interventions 'clearly effective' also overlooks the nonsignificant technology-specific subgroup results. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Two reviews found that no single virtual care strategy was superior for reducing HbA1c.

    “Two reviews compared different virtual care strategies and found that no single strategy was superior for reducing HbA1c [20, 48].”

    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 [48]

  • Three reviews reported that telemonitoring combined with tele-education and telemonitoring combined with healthcare professional feedback had greater effects.

    “Of those, 3 reviews reported telemonitoring combined with tele-education [44] and telemonitoring combined with healthcare professional feedback [45, 48] had greater effects.”

    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 [48]

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Sorted by citations

Authors
Robson, N., & Hosseinzadeh, H.
Affiliations
University of Wollongong (AU)
Corresponding author
Robson, Natalie
ORCID
Venue
International Journal of Environmental Research and Public Health
Publisher
MDPI AG
Published
2021-11-19
Volume
18
Issue
22
Pages
12171
ISSN
1660-4601 (ISSN-L)
DOI
10.3390/ijerph182212171
PMC
PMC8622760
OpenAlex
W3215730038
Cited by
55
References
11
Citations by year
2026: 8 · 2025: 11 · 2024: 13 · 2023: 15 · 2022: 8
FWCI
1.60
Type
journal article
Language
en
Open access
Licence
Locations
  • International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Research Online (University of Wollongong) (submittedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
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, glycemic control, self-management behavior, primary care, remote patient monitoring, mobile health, telephone communication
MeSH terms
Self-Management, Adult, Communication, Diabetes Mellitus, Type 2, Humans, Primary Health Care, Randomized Controlled Trials as Topic, Telemedicine

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