Telemedicine had no convincing effect on quality of life , mortality or hypoglycemia .
INTERPRETATION : Compared with usual care , the addition of telemedicine , especially systems that allowed medication adjustments with or without text messaging or a Web portal , improved HbA1C but not other clinical ly relevant outcomes among patients with diabetes
BACKGROUND : Telemedicine , the use of telecommunications to deliver health services , expertise and information , is a promising but unproven tool for improving the quality of  diabetes care  .
We summarized the effectiveness of different methods of telemedicine for the management of diabetes compared with usual care .
An Automated Telephone Nutrition Support System for Spanish-Speaking Patients With Diabetes
Background : In the United States , Spanish-speaking patients with diabetes often receive inadequate dietary counseling . Providing language and culture-concordant dietary counseling on an ongoing basis is critical to diabetes self-care . Objective : To determine if automated telephone nutrition support ( ATNS ) counseling could help patients improve glycemic control by duplicating a successful pilot in Mexico in a Spanish-speaking population in Oakl and , California . Design : A prospect i ve r and omized open-label trial with blinded endpoint assessment ( PROBE ) was performed . Participants : The participants were seventy-five adult patients with diabetes receiving care at a federally qualified health center in Oakl and , California . Interventions : ATNS , a computerized system that dialed patients on their phones , prompted them in Spanish to enter ( via keypad ) portions consumed in the prior 24 hours of various cultural-specific dietary items , and then provided dietary feedback based on proportion of high versus low glycemic index foods consumed . The control group received the same ATNS phone calls 14 weeks after enrollment . Main Measures : The primary outcome was hemoglobin A1c % ( A1c ) 12 weeks following enrollment . Key Results : Participants had no significant improvement in A1c ( –0.3 % in the control arm , –0.1 % in the intervention arm , P = .41 for any difference ) or any secondary parameters . Conclusions : In our study , an ATNS system did not improve diabetes control in a Spanish-speaking population in Oakl and
Telemedicine had no convincing effect on quality of life , mortality or hypoglycemia .
INTERPRETATION : Compared with usual care , the addition of telemedicine , especially systems that allowed medication adjustments with or without text messaging or a Web portal , improved HbA1C but not other clinical ly relevant outcomes among patients with diabetes
BACKGROUND : Telemedicine , the use of telecommunications to deliver health services , expertise and information , is a promising but unproven tool for improving the quality of  diabetes care  .
We summarized the effectiveness of different methods of telemedicine for the management of diabetes compared with usual care .