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 .
Effect of telehealth on glycaemic control: analysis of patients with type 2 diabetes in the Whole Systems Demonstrator cluster randomised trial
Background The Whole Systems Demonstrator was a large , pragmatic , cluster r and omised trial that compared telehealth with usual care among 3,230 patients with long-term conditions in three areas of Engl and .  Telehealth involved the regular transmission of physiological information such as blood glucose to health professionals working remotely . We examined whether telehealth led to changes in glycosylated haemoglobin ( HbA1c ) among the subset of patients with type 2 diabetes . Methods The general practice electronic medical record was used as the source of information on HbA1c . Effects on HbA1c were assessed using a repeated measures model that included all HbA1c readings recorded during the 12-month trial period , and adjusted for differences in HbA1c readings recorded before recruitment . Secondary analysis averaged multiple HbA1c readings recorded for each individual during the trial period . Results 513 of the 3,230 participants were identified as having type 2 diabetes and thus were included in the study . Telehealth was associated with lower HbA1c than usual care during the trial period ( difference 0.21 % or 2.3 mmol/mol , 95 % CI , 0.04 % to 0.38 % , p = 0.013 ) . Among the 457 patients in the secondary analysis , mean HbA1c showed little change for controls following recruitment , but fell for intervention patients from 8.38 % to 8.15 % ( 68 to 66 mmol/mol ) . A higher proportion of intervention patients than controls had HbA1c below the 7.5 % ( 58 mmol/mol ) threshold that was targeted by general practice s ( 30.4 % vs. 38.0 % ) . This difference , however , did not quite reach statistical significance ( adjusted odds ratio 1.63 , 95 % CI , 0.99 to 2.68 , p = 0.053 ) . Conclusions Telehealth modestly improved glycaemic control in patients with type 2 diabetes over 12 months . The scale of the improvements is consistent with previous meta-analyses , but was relatively modest and seems unlikely to produce significant patient benefit . Trial registration numberInternational St and ard R and omized Controlled Trial Number Register IS RCT N43002091
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 .