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

Telehealth and Telemedicine and Glycemic Control

Resumo

INTRODUCTION: Effective DM management relies on patient education to promote self-care. With expanding access to digital technologies, Telemedicine and Telehealth offer promising tools to enhance education and glycemic control in DM patients. OBJECTIVE: To evaluate the impact of Telehealth and Telemedicine interventions on glycemic control in patients with type 1 (DM1) and type 2 diabetes mellitus (DM2). METHODS: This narrative review includes randomized controlled trials (RCTs) published between January 2016 and December 2021. Inclusion criteria comprised studies involving DM1 and DM2, comparing the impact of Telehealth interventions on glycemic control with conventional follow-up. Exclusion criteria encompassed duplicate or inaccessible articles, short communications, book chapters, single-arm clinical trials, and studies lacking a detailed description of the Telehealth intervention. The databases searched included PubMed, ScienceDirect, SciELO, LILACS, and Cochrane. RESULTS: A total of 38 studies involving 7,891 patients were assessed. The mean age of patients ranged from 44 to 73 years, and follow-up durations varied from 3 to 18 months. Ten studies evaluated web-based programs, mobile apps, and text messages; among these, seven (70%) showed significant reductions in A1c, ranging from 0.2 to 1.7%. Twelve studies assessed device use and telemonitoring, with nine (75%) showing significant A1c reductions from 0.4 to 1.6%. Sixteen studies examined teleconsultations alongside usual diabetes care; twelve (75%) demonstrated significant A1c reductions, ranging from 0.5 to 3.1%. CONCLUSION: The incorporation of Telehealth/Telemedicine strategies into standard diabetes management shows a positive impact on patient care.