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 .
Stepwise Self-Titration of Oral Glucose-Lowering Medication Using a Mobile Telephone-Based Telehealth Platform in Type 2 Diabetes: A Feasibility Trial in Primary Care
Background : Telehealth-supported clinical interventions may improve diabetes self-management . We explored the feasibility of stepwise self-titration of oral glucose-lowering medication guided by a mobile telephone-based telehealth platform for improving glycemic control in type 2 diabetes . Methods : We recruited 14 type 2 diabetes patients to a one-year feasibility study with 1:1 r and omization . Intervention group patients followed a stepwise treatment plan for titration of oral glucose-lowering medication with self-monitoring of glycemia using real-time graphical feedback on a mobile telephone and remote nurse monitoring using a Web-based tool . We carried out an interim analysis at 6 months . Results : We screened 3476 type 2 diabetes patients ; 94 % of the ineligible did not meet the eligibility criteria for hemoglobin A1c ( HbA1c ) or current treatment . Mean ( st and ard deviation ) patient age at baseline was 58 ( 11 ) years , HbA1c was 65 ( 12 ) mmol/mol ( 8.1 % [ 1.1 % ] ) , body mass index was 32.9 ( 6.4 ) kg/m2 , median [ interquartile  range ( IQR ) ] diabetes duration  was 2.6 ( 0.6 to 4.7 ) years , and 10 ( 71 % ) were men . The median ( IQR ) change in HbA1c from baseline to six months was −10 ( −21 to 3 ) mmol/mol ( −0.9 % [ -1.9 % to 0 % ] ) in the intervention group and −5 ( −13 to 6 ) mmol/mol ( −0.5 % [ -1.2 % to 0.6 % ] ) in the control group . Six out of seven intervention group patients and four out of seven control group patients changed their oral glucose-lowering medication ( p = .24 ) . Conclusions : Self-titration of oral glucose-lowering medication in type 2 diabetes with self-monitoring and remote monitoring of glycemia is feasible , and further studies using adapted recruitment strategies are required to evaluate whether it improves clinical outcomes
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 .