Cited by 77Telemedicine and Telehealth ImplementationDiabetes Management and EducationMobile Health and mHealth Applications

Efficacy of telemedicine on glycaemic control in patients with type 2 diabetes: A meta-analysis

Open access
De Groot, Julia, Wu, Dongjun, Flynn, Declan, Robertson, Dylan, Grant, Gary, Sun, Jing·2021·World Journal of Diabetes

Abstract

BACKGROUND: remote communication and technology. It is a convenient and cost-effective method of intervention, which has shown to be successful in improving glyceamic control for type 2 diabetes patients. The utility of a successful diabetes intervention is vital to reduce disease complications, hospital admissions and associated economic costs. AIM: To evaluate the effects of telemedicine interventions on hemoglobin A1c (HbA1c), systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), post-prandial glucose (PPG), fasting plasma glucose (FPG), weight, cholesterol, mental and physical quality of life (QoL) in patients with type 2 diabetes. The secondary aim of this study is to determine the effect of the following subgroups on HbA1c post-telemedicine intervention; telemedicine characteristics, patient characteristics and self-care outcomes. METHODS: for heterogeneity testing. The mean difference and standard deviation data were extracted for analysis. RESULTS: modes of videoconference or interactive telephone had the greatest effect on HbA1c reduction. In addition, interventions delivered at a less than weekly frequency, as well as those given for a duration of 6 mo, and those lead by allied health resulted in better HbA1c outcomes. Furthermore, interventions with a focus on biomedical parameters, as well as those with an engagement level > 70% and those with a drop-out rate of 10%-19.9% showed greatest HbA1c reduction. The patient characteristics investigation reported that Hispanic patients with T2DM had a greater HbA1c reduction post telemedicine intervention. For self-care outcomes, telemedicine interventions that resulted in higher post-intervention glucose monitoring and self-efficacy were shown to have better HbA1c reduction. CONCLUSION: a clinical treatment model and with a focus on biomedical parameters, delivered at a less than weekly frequency and 6 mo duration would have the largest effect on HbA1c reduction. This is in addition to being led by allied health, through modes such as video conference and interactive telephone, with an intervention engagement level > 70% and a drop-out rate between 10%-19.9%. Due to the high heterogeneity of included studies and limitations, further studies with a larger sample size is needed to confirm our findings.

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  • 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 [44]

    The Results (page unavailable) report a significant HbA1c reduction for videoconference interventions. The paper analyzes intervention duration separately, however, and does not establish that the videoconference finding applies specifically across 3–12 months; its Data extraction table includes a five-year intervention with videoconferencing. (LLM, conf=0.86)

    Experimental — accuracy not yet measured
  • 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 [44]

    The Results (page not available) report that telemonitoring reduced HbA1c and that interventions led by healthcare professionals differed in effect. The Data extraction table also includes telemonitoring studies with professional feedback. But the paper does not report that adding professional feedback to telemonitoring produced greater effects than telemonitoring without it; its subgroup analysis instead reports a greater HbA1c reduction for telemonitoring alone than for telemonitoring combined with tele-education. (LLM, conf=0.82)

    Experimental — accuracy not yet measured
  • Only one study included in the BMI meta-analysis reported the BMI measure for type 2 diabetes, and all other three reviews included combined results for mixed type of diabetes.

    “Only one study [44] included in this analysis reported the BMI measure for type 2 diabetes and all other three reviews included combined results for mixed type of diabetes.”
  • 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.”

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Research works printed but not linked: 1

  1. [78]Yip MP Effectiveness of a nurse coordinated system of telemedicine care for patients with type 2 diabetes mellitus. Ph.D Thesis, Ann Arbor: The Chinese University of Hong Kong (Hong Kong). 2002

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Authors
De Groot, J., Wu, D., Flynn, D., Robertson, D., Grant, G., & Sun, J.
Affiliations
Griffith University (AU)
Corresponding author
Sun, Jing
Venue
World Journal of Diabetes
Published
2021-02-15
Volume
12
Issue
2
Pages
170-197
ISSN
1948-9358 (ISSN-L)
OpenAlex
W3121604829
Cited by
77
References
98
Citations by year
2026: 10 · 2025: 20 · 2024: 11 · 2023: 18 · 2022: 14 · 2021: 4
FWCI
2.09
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • World Journal of Diabetes (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Griffith Research Online (submittedVersion, cc-by-nc)
  • Griffith Research Online (Griffith University, Queensland, Australia) (submittedVersion, cc-by-nc)
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, glycemic control, HbA1c, videoconferencing, allied health, intervention engagement, self-care, glucose monitoring, self-efficacy, Hispanic patients, blood pressure, body mass index, quality of life

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