There were three reported  deaths out of 3578 participants .Computer-based  diabetes self-management interventions currently have limited effectiveness .
Current interventions do not show adequate evidence for improving depression , health-related quality of life or weight .
AUTHORS ' CONCLUSIONS Computer-based diabetes self-management interventions to manage type 2 diabetes appear to have a small beneficial effect on blood glucose control and the effect was larger in the mobile phone subgroup .
There is no evidence to show benefits in other biological outcomes or any cognitive , behavioural or emotional outcomes
BACKGROUND Diabetes is one of the commonest chronic medical conditions , affecting around 347 million adults worldwide .
Structured patient education programmes reduce the risk of diabetes-related complications four-fold .
Internet-based self-management programmes have been shown to be effective for a number of long-term conditions , but it is unclear what are the essential or effective components of such programmes .
If computer-based self-management interventions improve outcomes in type 2 diabetes , they could potentially provide a cost-effective option for reducing the burdens placed on patients and healthcare systems by this long-term condition .
OBJECTIVES To assess the effects on health status and health-related quality of life of computer-based diabetes self-management interventions for adults with type 2 diabetes mellitus .
Telemedicine intervention effects on waist circumference and body mass index in the IDEATel project.
BACKGROUND We examine the changes in waist circumference ( WC ) and body mass index ( BMI ) in older adults enrolled in a diabetes telemedicine program . The subjects were elderly Medicare beneficiaries participating in the rural ( upstate New York ) cohort of Informatics and Diabetes Education and Telemedicine , a r and omized , controlled trial using telemedicine to improve diabetes care in which the primary outcome was glycemic control . METHODS Ninety-two percent of the subjects had BMI > 25 kg/m(2 ) , and 65.8 % had a BMI > or = 30 kg/m(2 ) . Intervention subjects received home televisits with a dietitian or nurse educator every 4 - 6 weeks .  Blood glucose and blood pressure values  were review ed , and lifestyle and medication changes were recommended . Non-intervention subjects received usual care through their primary care physicians . Change in WC , BMI , diet , and exercise behaviors and knowledge were examined at baseline and 12 and 24 months . A mixed-effects path analysis was performed to examine direct and indirect effects . RESULTS The telemedicine participants increased diet and exercise knowledge over time ( P < 0.001 ) . It was estimated that women in the  telemedicine  group reduced their WC over the 2 years by 1.2 cm , whereas women in the usual care group increased their WC by almost 1 cm ( P = 0.02 ) . Path analysis demonstrated that the intervention , through improved diet and exercise knowledge , was related to the decrease in WC ( P = 0.006 ) and BMI ( P = 0.004 ) . CONCLUSIONS Diabetes case management using telemedicine improved self-reported diet and exercise knowledge , practice s , and behaviors , which in turn was associated with reductions in WC and BMI at 2 years
There were three reported  deaths out of 3578 participants .Computer-based  diabetes self-management interventions currently have limited effectiveness .
Current interventions do not show adequate evidence for improving depression , health-related quality of life or weight .
AUTHORS ' CONCLUSIONS Computer-based diabetes self-management interventions to manage type 2 diabetes appear to have a small beneficial effect on blood glucose control and the effect was larger in the mobile phone subgroup .
There is no evidence to show benefits in other biological outcomes or any cognitive , behavioural or emotional outcomes
BACKGROUND Diabetes is one of the commonest chronic medical conditions , affecting around 347 million adults worldwide .
Structured patient education programmes reduce the risk of diabetes-related complications four-fold .
Internet-based self-management programmes have been shown to be effective for a number of long-term conditions , but it is unclear what are the essential or effective components of such programmes .
If computer-based self-management interventions improve outcomes in type 2 diabetes , they could potentially provide a cost-effective option for reducing the burdens placed on patients and healthcare systems by this long-term condition .
OBJECTIVES To assess the effects on health status and health-related quality of life of computer-based diabetes self-management interventions for adults with type 2 diabetes mellitus .