Telehealth in patients with diabetes: a systematic review and meta-analysis project

Purpose: The purpose of this review was to examine the best available evidence on self-management outcomes for patients with diabetes type 1 or type 2, that use telehealth or telemedicine (TM) vs. usual care (UC) or face-to-face visits for treatment.Methodology: A search of four databases, and relevant organizational websites revealed 450 titles. After duplicates were removed, 254 studies were screened by title and abstract for eligibility. Eighty-three full-text articles were retrieved, and each was assessed for eligibility. Seventy-five articles were excluded. The remaining eight full-text articles were critically appraised and included in this review. Results: The usage of telemedicine in patients with diabetes did show statistically significant reductions in HgbA1C (95% CI -0.25, -0.06), in systolic blood pressure (95% CI -0.25, -0.06), and in diastolic blood pressure (95% CI -0.26, -0.04), but not in LDL cholesterol with usage of TM (95% CI -0.41, -0.02). Implications for Practice: The usage of TM in some of the studies did show some improvement in self-management as evidenced by self-blood glucose monitoring, adherence to medications as well as appointments via online. Many studies showed a positive correlation between TM and reduction in HgbA1C, systolic and diastolic BP, but not a significant reduction in LDL cholesterol. The studies included in this review did show an increased connectivity with providers via Electronic Medical Record (EMR), videoconferencing, and secure emailing can increase participants knowledge about their disease, confidence in self-managing their illness and a stronger bond with their providers as opposed to UC or face-to-face visits. However, it is not clear what form of virtual education is most effective. Some of the studies connected participants to educational websites, other providers provided their own educational modules. Some of the studies relied on secure email messages to provide insight into treatment, medication changes or dietary adjustments for example.D.N.P.Includes bibliographical reference