Results Telemedicine programs that include a nutritional component show similar effect in diabetes management as those programs that do not .
Furthermore , subgroup analysis reveals that nutritional intervention via SMS such as email and text messages is at least as equally effective in reducing HbA1c when compared to personal nutritional counseling with a practitioner over videoconference or telephone .
Conclusion The inclusion of nutritional counseling as part of a telemedicine program does not make a significant difference to diabetes outcomes .
Incorporating nutritional counseling into telemedicine programs via SMS is at least as effective as counseling via telephone or videoconference
Background A growing number of studies and review s have documented the impact of telemedicine on diabetes management .
However , no meta- analysis has assessed whether including nutritional counseling as part of a telemedicine program has a significant impact on diabetes outcomes or what kind of nutritional counseling is most effective .
Influence of health care providers on the development of diabetes complications: long-term follow-up from the Pittsburgh Epidemiology of Diabetes Complications Study.
OBJECTIVE To quantify total diabetes care received ( generalist or specialist ) from diagnosis onward and its association with the incidence of diabetes complications in a representative cohort of patients with type 1 diabetes . RESEARCH DESIGN AND METHODS A total of 429 subjects from the Pittsburgh Epidemiology of Diabetes Complications Study , a prospect i ve follow-up study of childhood-onset type 1 diabetic subjects first seen between 1986 and 1988 ( mean age 28 years , mean duration 19 years ) , followed biennially for up to 10 years were studied . Specialist care was defined as care received from a board-certified endocrinologist , diabetologist , or diabetes clinic and quantified as the percent of diabetes duration spent in specialist care . RESULTS There was a significant trend for a higher incidence of neuropathy , overt nephropathy , and coronary artery disease with lower use of specialist care . Multivariate analyses controlling for diabetes duration , demographic characteristics , health care practice s , and physiological risk factors demonstrated that higher past use of specialist care was found to be significantly protective against the development of overt nephropathy ( risk ratio 0.43 , 95 % CI 0.21 - 0.88 ) and neuropathy ( 0.54 , 0.35 - 0.83 ) and weakly protective against coronary artery disease ( 0.65 , 0.37 - 1.1 ) . CONCLUSIONS A higher proportion of diabetes duration spent in specialist care may result in delayed development of certain diabetes complications independent of other risk factors . This study thus supports the concept that the benefits of specialist care should be available to all patients with type 1 diabetes
Results Telemedicine programs that include a nutritional component show similar effect in diabetes management as those programs that do not .
Furthermore , subgroup analysis reveals that nutritional intervention via SMS such as email and text messages is at least as equally effective in reducing HbA1c when compared to personal nutritional counseling with a practitioner over videoconference or telephone .
Conclusion The inclusion of nutritional counseling as part of a telemedicine program does not make a significant difference to diabetes outcomes .
Incorporating nutritional counseling into telemedicine programs via SMS is at least as effective as counseling via telephone or videoconference
Background A growing number of studies and review s have documented the impact of telemedicine on diabetes management .
However , no meta- analysis has assessed whether including nutritional counseling as part of a telemedicine program has a significant impact on diabetes outcomes or what kind of nutritional counseling is most effective .