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 .
A feasibility study of mobile phone text messaging to support education and management of type 2 diabetes in Iraq.
BACKGROUND We undertook a feasibility study to evaluate feasibility and utility of short message services ( SMSs ) to support Iraqi adults with newly diagnosed type 2 diabetes . SUBJECTS AND METHODS Fifty patients from a teaching hospital clinic in Basrah in the first year after diagnosis were recruited to receive weekly SMSs relating to diabetes self-management  over 29 weeks . Numbers of messages received , acceptability , cost , effect on glycated hemoglobin ( HbA1c ) , and diabetes knowledge were documented . RESULTS Forty-two patients completed the study , receiving an average 22 of 28 messages . Mean knowledge score rose from 8.6 ( SD 1.5 ) at baseline to 9.9 ( SD 1.4 ) 6 months after receipt of SMSs ( P=0.002 ) . Baseline and 6-month knowledge scores correlated ( r=0.297 , P=0.049 ) . Mean baseline HbA1c was 79 mmol/mol ( SD 14 mmol/mol ) ( 9.3 % [ SD 1.3 % ] ) and decreased to 70 mmol/mol ( SD 13 mmol/mol ) ( 8.6 % [ SD 1.2 % ] ) ( P=0.001 ) 6 months after the SMS intervention . Baseline and 6-month values were correlated ( r=0.898 , P=0.001 ) . Age , gender , and educational level showed no association with changes in HbA1c or knowledge score . Changes in knowledge score were correlated with postintervention HbA1c ( r=-0.341 , P=0.027 ) . All patients were satisfied with text messages and wished the service to be continued after the study . The cost of SMSs was € 0.065 per message . CONCLUSIONS This study demonstrates SMSs are acceptable , cost-effective , and feasible in supporting diabetes care in the challenging , re source -poor environment of modern-day Iraq . This study is the first in Iraq to demonstrate similar benefits of this technology on diabetes education and management to those seen from its use in better-re source d parts of the world . A r and omized controlled trial is needed to assess precise benefits on self-care and knowledge
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 .