Telehealth Succeeds in Managing Type 2 Diabetes, Studies Show

Telehealth strategies and interventions are effective at lowering hemoglobin A1C levels in adults with type 2 diabetes, according to a systematic review and meta-analysis of randomized controlled trials.

Ninety percent of the over 400 million cases of diabetes in the world are type 2 diabetes. Individuals manage the chronic condition mainly by preventing complications and disease progression through healthy diets, exercise, and medication.

Primary care providers started leveraging different types of telehealth strategies to help patients manage their diabetes during the COVID-19 pandemic.

Australian researchers compiled a set of 29 studies that focused on using telehealth instead of in-person care for type 2 diabetes management. The studies were all published between January 2011 and September 2021 and used a randomized controlled trial design.

The researchers’ main aim was to understand if telehealth interventions helped lower A1C levels—also known as blood glucose levels—in patients living with type 2 diabetes.

Out of the 29 studies included in the systematic review, 17 leveraged telemonitoring—or remote patient monitoring—10 used mHealth devices, three studies employed telephone communication, two used virtual conferencing, and one study leveraged video education tools. A handful of the studies used more than one of these telehealth interventions to help patients manage their condition.

Most of the study periods lasted for 6 or 12 months, though the range of intervention length was between 3 months and 5 years. Participant age ranged from 38 to 78 years, with an average age of 56.

About half of the 17 studies that used remote patient monitoring for type 2 diabetes management reported that the telehealth group saw a significant reduction in A1C levels compared to the in-person group. In the eight studies that didn’t see any significant differences for this outcome between the two groups, the telehealth group had notable reductions in outpatient and emergency department visits, as well as hospitalizations.

Four out of the 10 studies that leveraged mHealth interventions saw a significant reduction in A1C levels for the telehealth patients compared to the in-person group. The remaining six studies saw improvements in quality of life and self-management behaviors as a result of mHealth intervention, the systematic review stated.

In the remaining studies that utilized virtual conferencing, telephone communication, and video education, the majority (five out of six studies) saw notable improvements in A1C level reduction.

The telehealth study pools also saw improvements in mental health, body mass index, diabetes self-management behaviors, systolic blood pressure, and fasting plasma glucose levels.

Overall, telehealth was effective in helping patients manage their type 2 diabetes.

“Results from the meta-analysis indicate that telehealth interventions, irrespective of the telehealth technology used, had greater influence on reducing HbA1c levels compared to usual care,” the researchers wrote. “The narrative synthesis of the studies suggests that telemonitoring and telephone communication interventions had the greatest influence on HbA1c levels [among] adults living with type 2 diabetes.”

Additionally, intervention methods that included some type of personalized feedback about type 2 diabetes management were more likely to see significant changes in A1C levels. This suggests that providers who engage with patients and provide feedback can play an important role in improving the effectiveness of managing type 2 diabetes via telehealth.