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 .
Assessment of Barriers to Improve Diabetes Management in Older Adults
OBJECTIVE To evaluate whether assessment of barriers to self-care and strategies to cope with these barriers in older adults with diabetes is superior to usual care with attention control . The American Diabetes Association guidelines recommend the assessment of age-specific barriers . However , the effect of such strategy on outcomes is unknown . RESEARCH DESIGN AND METHODS We r and omized 100 subjects aged ≥69 years with poorly controlled diabetes ( A1C > 8 % ) in two groups . A geriatric diabetes team assessed barriers and developed strategies to help patients cope with barriers for an intervention group . The control group received equal amounts of attention time . The active intervention was performed for the first 6 months , followed by a “ no-contact ” period . Outcome measures included A1C , Tinetti test , 6-min walk test ( 6MWT ) , self-care frequency , and diabetes-related distress . RESULTS We assessed 100 patients ( age 75 ± 5 years , duration 21 ± 13 years , 68 % type 2 diabetes , 89 % on insulin ) over 12 months . After the active period , A1C decreased by −0.45 % in the intervention group vs. −0.31 % in the control group . At 12 months , A1C decreased further in the intervention group by −0.21 % vs. 0 % in control group ( linear mixed-model , P < 0.03 ) . The intervention group showed additional benefits in scores on measures of self-care ( Self-Care Inventory-R ) , gait and balance ( Tinetti ) , and endurance ( 6MWT ) compared with the control group . Diabetes-related distress improved in both groups . CONCLUSIONS Only attention between clinic visits lowers diabetes-related distress in older adults . However , communication with an educator cognizant of patients ’ barriers improves glycemic control and self-care frequency , maintains functionality , and lowers distress in this population
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 .