A Meta-Analysis of the Effectiveness of Telemedicine in Glycemic Management among Patients with Type 2 Diabetes in Primary Care

Abstract

Introduction: Telemedicine interventions are gradually being used in primary health care to help patients with type 2 diabetes receive ongoing medical guidance. The purpose of this study was to analyze the effectiveness of using telemedicine in primary health care for the management of patients with type 2 diabetes. Methods: A systematic search was conducted from database inception to August 2021 in nine databases, including PubMed, Web of Science, Cochrane Library, EMBASE, EBSCO, CNKI, Wanfang Data, VIP, and CBM. Data extraction and quality assessment were performed for studies that met the inclusion criteria. The meta-analysis was performed using Review Manager 5.4 (Cochrane) and Stata v.16.0SE (College Station, TX, USA). Results: A total of 32 articles were included in this study. Analysis showed a reduction in glycated hemoglobin, fasting glucose, and postprandial glucose after the telemedicine intervention. Systolic blood pressure and self-efficacy improved significantly, but there was no significant improvement in weight, lipid metabolism, or diabetes awareness. Subgroup analysis based on the duration of intervention showed significant improvement in glycated hemoglobin at 6 months of intervention. Conclusions: Telemedicine interventions may help patients with type 2 diabetes to effectively control blood glucose and improve self-management in primary health care. There is only moderate benefit, and the benefit may not be sustained beyond 6 months. However, the evidence for the improvement in lipid metabolism is insufficient and further studies are needed.

Adapting to Telemedicine in Diabetes

“…A meta-analysis of 32 articles on telemedicine in primary healthcare for the management of patients with Type 2 diabetes demonstrated that telemedicine had a favourable effect on diabetes care. 2 Holt described the outcomes of the study, which showed that telemedicine interventions may help patients with Type 2 diabetes to effectively control blood glucose and improve self-management in primary healthcare. The analysis showed that telemedicine leads to a reduction in HbA1c, a reduction in fasting and postprandial glucose, and reduction in blood pressure.…”

Redes De Atenção E Práticas De Cuidados Em Saúde À Crianças E Adolescentes Com Doenças Crônicas Em Tempos De Covid-19

“…Sobre o nível de escolaridade, a maioria (22) cursava o Ensino Fundamental II (6º a 9º ano); seguido de 34% (17) no Ensino Fundamental I (1º ao 5 ano); (7) no ensino médio (1º ao 3º) e apenas (2) na Educação Infantil. A maior procedência era de crianças e adolescentes advindas do interior do Estado do Ceará 50% (25); seguidos dos moradores da capital 38% (19) e, apenas 12% (6) da Região Metropolitana, como visto na tabela 1 abaixo.…”

“…Há evidências na literatura científica que apontam resultados promissores sobre o uso da Telessaúde como um aumento expressivo da utilização dessa ferramenta digital durante a pandemia, o que favoreceu para limitação do contato das pessoas e contribuindo para a redução da transmissão viral 22 .…”

The Association of Telehealth Availability and Quality of Care Measures for Patients With Diabetes at Federally Qualified Health Centers: Retrospective Cohort Study

“…Telehealth has the potential to improve access to and quality of care for low-income patients with chronic conditions such as diabetes [1][2][3][4]. This includes patients served by federally qualified health centers (FQHCs), which provide comprehensive primary and preventive care services to millions of low-income patients across the United States.…”