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 .
UKPDS 26: Sulphonylurea failure in non-insulin-dependent diabetic patients over six years. UK Prospective Diabetes Study (UKPDS) Group.
Patients with Type 2 ( non-insulin-dependent ) diabetes mellitus ( DM ) on sulphonylurea therapy convert to insulin progressively as the sulphonylureas ' fail ' . The rate of failure and the features of those who fail have been poorly described . To assess secondary failure rates of sulphonylureas , we report on the responses in 1305 patients with newly diagnosed Type 2 DM r and omly allocated to therapy with either chlorpropamide or glibenclamide in the UK Prospect i ve Diabetes Study ( UKPDS ) . These patients were initially treated by diet for 3 months and had a fasting plasma glucose > 6 mmol l(-1 ) ; mean age 53 ( SD 9 ) years ; BMI 26.8 ( SD 5.0 ) kg m(-2 ) ; and median fasting plasma glucose 9.1 ( 7.6 - 12.5 quartiles ) mmol l(-1 ) . If their fasting plasma glucose subsequently rose above 15.0 mmol l(-1 ) , or they developed hyperglycaemic symptoms , additional hypoglycaemic therapy was given : metformin , ultratard insulin , and soluble insulin as required . By 6 years , 44 % had required additional therapy . Of those r and omized to glibenclamide , 48 % required additional therapy by 6 years , compared with 40 % of those allocated to chlorpropamide ( p < 0.01 ) . Sixty-one per cent , 39 % , and 23 % , respectively , of patients with fasting plasma glucose > or = 10.0 mmol l(-1 ) , > or = 7.8 mmol l(-1 ) to < 10.0 mmol l(-1 ) and < 7.8 mmol l(-1 ) at r and omization required additional therapy ( p < 0.001 ) . In the initial 3 years , non-obese subjects ( BMI < 30 kg m(-2 ) ) were more likely to require additional therapy than obese patients ( BMI > or = 30 kg m(-2 ) ) ( 43 % vs 53 % at 6 years ; p < 0.001 ) . Modelled beta-cell function showed that those with lower function were more likely to fail ( p < 0.0001 ) . Thus sulphonylureas fail as a therapeutic agent at rates which are dependent both on the phenotype at presentation and perhaps on the agent used initially . Higher failure rates were found in those with higher glucose concentrations , those who were younger , those with lower beta-cell reserve and those r and omized to glibenclamide compared with chlorpropamide
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 .