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 .
Evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes and related complications.
H istorically , nutrition principles and recommendations for diabetes and related complications have been based on scientific evidence and diabetes knowledge when available and , when evidence was not available , on clinical experience and expert consensus . Often it has been difficult to discern the level of evidence used to construct the nutrition principles and recommendations . Furthermore , in clinical practice , many nutrition recommendations that have no scientific supporting evidence have been and are still being given to individuals with diabetes . To address these problems and to incorporate the research done in the past 8 years , this 2002 technical review provides principles and recommendations classified according to the level of evidence available . It review s the evidence from r and omized , controlled trials ; cohort and case-controlled studies ; and observational studies , which can also provide valuable evidence ( 1,2 ) , and takes into account the number of studies that have provided consistent outcomes of support . In this review , nutrition principles are grade d into four categories based on the available evidence : those with strong supporting evidence , those with some supporting evidence , those with limited supporting evidence and those based on expert consensus . Evidence -based nutrition recommendations attempt to translate research data and clinical ly applicable evidence into nutrition care . However , the best available evidence must still be moderated by individual circumstances and preferences . The goal of evidence -based recommendations is to improve the quality of clinical judgments and facilitate costeffective care by increasing the awareness of clinicians and patients with diabetes of the evidence supporting nutrition services and the strength of that evidence , both in quality and quantity . Before 1994 , the American Diabetes Association ’s ( ADA ’s ) nutrition principles and recommendations attempted to define an “ ideal ” nutrition prescription that would apply to everyone with diabetes ( 3–5 ) . Although individualization was a major principle of all recommendations , it was usually done within defined limits for recommended energy intake and macronutrient composition . The 1994 nutrition recommendations shifted this focus to one that emphasized effects of  nutrition therapy  on metabolic control ( 6,7 ) . The nutrition prescription is determined considering treatment goals and lifestyle changes the diabetic patient is willing and able to make , rather than predetermined energy levels and percentages of carbohydrate , protein , and fat . The goal of nutrition intervention is to assist and facilitate individual lifestyle and behavior changes that will lead to improved metabolic control . This focus continues with the 2002 nutrition principles and recommendations . Medical nutrition therapy ( MNT ) is an integral component of diabetes management ( 8,9 ) and diabetes sel fmanagement education ( 10 ) . ( Medical nutrition therapy is the preferred term and should replace other terms , such as diet , diet therapy , and dietary management .  ) MNT for diabetes includes the process and the system by which nutrition care is provided for diabetic individuals and the specific lifestyle recommendations for that care . However , recommendations should not only be based on scientific evidence but should also take into consideration lifestyle changes the ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ●
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 .