Impact of Telehealth and Telemedicine on Glycemic Control in Adults Patients with Diabetes Mellitus: A Narrative Synthesis.

Telehealth and Telemedicine and Glycemic Control

Abstract

INTRODUCTION: Telemedicine-based care strategies can be effective in supporting patients with diabetes mellitus. OBJECTIVE: To evaluate the impact of Telehealth and Telemedicine interventions on glycemic control in patients with DM1 and DM2. METHODS: This is a systematic review of randomized controlled trials, published in English, Portuguese, or Spanish, between January 2016 and December 2021. The databases used were PUBMED, Science Direct, Scielo, LILACS, and Cochrane. RESULTS: In total, the 38 studies assessed 7,891 patients, with 4,371 individuals in the intervention group and 3,520 in the control group. Mean age of the patients ranged from 44 to 73 years. The follow-up duration varied from 3 to 18 months. Ten studies evaluated the impact of web-based programs, mobile apps, and mobile text messages. Among these, seven (70%) showed a significant reduction in A1c, ranging from 0.2 to 1.7%. Twelve studies assessed the impact of device utilization and telemonitoring on glycemic control. Of these, nine (75%) showed a significant reduction in A1c, ranging from 0.4 to 1.6%. Sixteen studies assessed the implementation of teleconsultations in addition to usual care for diabetes. Among these, twelve (75%) demonstrated a significant reduction in A1c, ranging from 0.5 to 3.1%. The nature of the intervention in the study prevented participant blinding, which was the main bias in the studies included in this review. CONCLUSION: The incorporation of Telehealth/Telemedicine strategies into conventional therapy demonstrates a favorable effect on the management of patients with diabetes.

KEYWORDS: Diabetes Mellitus, Glycated Hemoglobin, Telemedicine, Telehealth.