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 .
An evaluation of Birmingham Own Health® telephone care management service among patients with poorly controlled diabetes. a retrospective comparison with the General Practice Research Database
Background Telephone-based care management programmes have been shown to improve health outcomes in some chronic diseases . Birmingham Own Health ® is a telephone-based care service ( nurse-delivered motivational coaching and support for self-management and lifestyle change ) for patients with poorly controlled diabetes , delivered in Birmingham , UK . We used a novel method to evaluate its effectiveness in a real-life setting . Methods Retrospective cohort study in the UK . 473 patients aged ≥ 18 years with diabetes enrolled onto Birmingham Own Health ® ( intervention cohort ) and with > 90 days follow-up , were each matched by age and sex to up to 50 patients with diabetes registered with the General Practice Research Data base ( GPRD ) to create a pool of 21,052 controls ( control cohort ) . Controls were further selected from the main control cohort , matching as close as possible to the cases for baseline test levels , followed by as close as possible length of follow-up ( within + /-30 days limits ) and within + /-90 days baseline test date . The aim was to identify a control group with as similar distribution of prognostic factors to the cases as possible . Effect sizes were computed using linear regression analysis adjusting for age , sex , deprivation quintile , length of follow-up and baseline test levels . Results After adjusting for baseline values and other potential confounders , the intervention showed significant mean reductions among people with diabetes of 0.3 % ( 95%CI 0.1 , 0.4 % ) in HbA1c ; 3.5 mmHg ( 1.5 , 5.5 ) in systolic blood pressure , 1.6 mmHg ( 0.4 , 2.7 ) in diastolic blood pressure and 0.7 unit reduction ( 0.3 , 1.0 ) in BMI , over a mean follow-up of around 10 months . Only small effects were seen on average on serum cholesterol levels ( 0.1 mmol/l reduction ( 0.1 , 0.2 ) ) . More marked effects were seen for each clinical outcome among patients with worse baseline levels . Conclusions Despite the limitations of the study design , the results are consistent with the Birmingham Own Health ® telephone care management intervention being effective in reducing HbA1c levels , blood pressure and BMI in people with diabetes , to a degree comparable with r and omised controlled trials of similar interventions and clinical ly important . The effects appear to be greater in patients with poorer baseline levels and the intervention is effective in the most deprived population
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 .