The review indicates that most telemedicine strategies can be useful , either as an adjunct or to replace usual care , leading to clinical ly meaningful reduction in HbA1c
The effects of telemedicine strategies on the management of diabetes is not clear .
This study aim ed to investigate the impact of different telemedicine strategies on glycaemic control management of type 2 diabetes patients .
Health Coaching Reduces HbA1c in Type 2 Diabetic Patients From a Lower-Socioeconomic Status Community: A Randomized Controlled Trial
Background Adoptions of health behaviors are crucial for maintaining good health after type 2 diabetes mellitus ( T2DM ) diagnoses . However , adherence to glucoregulating behaviors like regular exercise and balanced diet can be challenging , especially for people living in lower-socioeconomic status ( SES ) communities . Providing cost-effective interventions that improve self-management is important for improving quality of life and the sustainability of health care systems . Objective To evaluate a health coach intervention with and without the use of mobile phones to support health behavior change in patients with type 2 diabetes . Methods In this noninferiority , pragmatic r and omized controlled trial ( RCT ) , patients from two primary care health centers in Toronto , Canada , with type 2 diabetes and a glycated hemoglobin/hemoglobin A1c ( HbA1c ) level of ≥7.3 % ( 56.3 mmol/mol ) were r and omized to receive 6 months of health coaching with or without mobile phone monitoring support . We hypothesized that both approaches would result in significant HbA1c reductions , although health coaching with mobile phone monitoring would result in significantly larger effects . Participants were evaluated at baseline , 3 months , and 6 months . The primary outcome was the change in HbA1c from baseline to 6 months ( difference between and within groups ) . Other outcomes included weight , waist circumference , body mass index ( BMI ) , satisfaction with life , depression and anxiety ( Hospital Anxiety and Depression Scale [ HADS ] ) , positive and negative affect ( Positive and Negative Affect Schedule [ PANAS ] ) , and quality of life ( Short Form Health Survey-12 [ SF-12 ] ) . Results A total of 138 patients were r and omized and 7 were excluded for a sub study ; of the remaining 131 , 67 were allocated to the intervention group and 64 to the control group  . Primary outcome data were available for 97 participants ( 74.0 % ) . While both groups reduced their HbA1c levels , there were no significant between-group differences in change of HbA1c at 6 months using intention-to-treat ( last observation carried forward [ LOCF ] ) ( P=.48 ) or per- protocol ( P=.83 ) principles . However , the intervention group did achieve an accelerated HbA1c reduction , leading to a significant between-group difference at 3 months ( P=.03 ) . This difference was reduced at the 6-month follow-up as the control group continued to improve , achieving a reduction of 0.81 % ( 8.9 mmol/mol ) ( P=.001 ) compared with a reduction of 0.84 % ( 9.2 mmol/mol)(P=.001 ) in the intervention group . Intervention group participants also had significant decreases in weight ( P=.006 ) and waist circumference ( P=.01 ) while controls did not . Both groups reported improvements in mood , satisfaction with life , and quality of life .  Conclusions Health coaching with and without access to mobile technology appeared to improve glucoregulation and mental health in a lower-SES , T2DM population . The accelerated improvement in the mobile phone group suggests the connectivity provided may more quickly improve adoption and adherence to health behaviors within a clinical diabetes management program . Overall , health coaching in primary care appears to lead to significant benefits for patients from lower-SES communities with poorly controlled type 2 diabetes . Trial Registration Clinical Trials.gov NCT02036892 ; http:// clinical trials.gov/ct2/show/NCT02036892 ( Archived by WebCite at http://www.webcitation.org/6b3cJYJOD
The review indicates that most telemedicine strategies can be useful , either as an adjunct or to replace usual care , leading to clinical ly meaningful reduction in HbA1c
The effects of telemedicine strategies on the management of diabetes is not clear .
This study aim ed to investigate the impact of different telemedicine strategies on glycaemic control management of type 2 diabetes patients .