Table 2.
The effectiveness of telemedicine in improved glycemic control, obesity control, and quality of life.
| Author, Year, Country | Study design | Follow-up period and n patients last visit | Primary Outcome | Secondary Outcome | Conclusion | ||
|---|---|---|---|---|---|---|---|
| Control | Telemedicine | Control | Telemedicine | ||||
| Hansel et al., 2017, France 8 | Randomized trial | 4 months, control group (n = 55), telemedicine group (n = 49) | Average change in HbA1c value was 0.23% (95% CI: 0.73) | Average change in HbA1c value was −0.37% (95% CI: 1.04) (p<0.001 vs. control) (n = 48) | Average change in body weight was 0.2 (kg) (95% CI: 2.6) | Average change in body weight was −2.9 (kg) (95% CI: 3.1) (p<0.001 vs. control) (n = 47) | Body weight and HbA1c changes improved significantly in the intervention |
| Kim and Jeong, 2007, South Korea 9 | A control group pretest–posttest design | 6 months, control group (n = 26), telemedicine group (n = 25) | HbA1c value was 7.70 ± 0.90%, FBG was 149.5 ± 39.3 mg/dl, 2 h post−meal glucose was 218.0 ± 82.0 mg/dl | HbA1c value was 7.04 ± 1.39% (p<0.05 vs. baseline) FBG was 145.7 ± 39.7 mg/dl, 2 h post−meal glucose was 192.6 ± 55.2 mg/dl (p<0.05 vs. baseline) | No data | No data | Web-based intervention using SMS of cellular phone improved HbA1c and 2HPMG for 6 months in type-2 diabetic patients |
| Basudev et al., 2016, United Kingdom 10 | Prospective randomized controlled study | 12 months, control group (n = 88), telemedicine group (n = 79) | HbA1c value was 9.4 ± 1.7%, change in HbA1c value was −0.8 ± 1.9 | HbA1c value was 9.6 ± 1.7%, change in HbA1c value was −0.6 ± 1.7 (p = 0.4 vs. control) | Change in body weight was 0.2 ± 5.4 (kg). Change in BMI was 0.20 ± 1.9 kg/m2 | Change in body value was 0.2 ± 5.4 (kg) (p = 0.99 vs. control), Change in BMI was 0.13 ± 2.0 kg/m2 (p = 0.84 vs. control) | The virtual clinic model showed improvement in metabolic control, HbA1c within 12 months, however it was not significantly superior to the control group |
| Nicolucci et al., 2015, Italy 11 | A randomized, parallel-group (1:1), open-label, multicenter study | 12 months, control group (n = 135), telemedicine group (n = 114) | HbA1c value was 7.78 ± 1.1% | HbA1c value was 7.44 ± 1.0% (p = 0.001 vs. control) | Body weight was 81.3 ± 14.3 kg | Body weight was 82.2 ± 15.4 kg (p = 0.66 vs. control), All SF−36 QoL scores improved in the telemedicine group but not in the control group | Use of the HT system was associated with better metabolic control and quality of life |
| Oh et al., 2003, South Korea 12 | A randomized comparison experimental design | 3 months, control group (n = 18), telemedicine group (n = 20) | Average change in HbA1c value was 0.6 ± 0.9% (p = 0.005 vs. baseline). . BG decreased of 6.9 ± 68.5 mg/dl (p = 0.675 vs. baseline). Two hours post−meal glucose was increased of 19.6 ± 75.3 mg/dl (p = 0.315 vs. baseline) | Average change in HbA1c value was −1.2 ± 1.5% (p = 0.002 vs. baseline, p = 0.000 vs. control). FBG decreased of 15.7 ± 52.0 mg/dl (p = 0.193 vs. baseline, p = 0.245 vs. control). Two hours postmeal glucose was decreased of 42.6 ± 114.8 mg/dl (p = 0.114 vs. baseline, p = 0.071 vs. control) | BMI increased of 0.2 ± 0.6 kg/m2 (p = 0.278 vs. baseline) | BMI increased of 0.3 ± 0.6 kg/m2 (p = 0.068 vs. baseline, p = 0.607 vs. control) | A near-normal glycemic control delivered by telephone would imrprove HbA1c, but would not significantly affect BMI |
| Stone et al., 2010, USA 13 | Randomized controlled trial | 6 months, home telemonitoring (n = 64), monthly care coordination telephone call (n = 73) | HbA1c value was 8.6 ± 1.3% | HbA1c value was 7.9 ± 1.2%, HbA1c was 0.7% lower than monthly care coordination telephone call (p < 0.001) | Body weight was 223.9 ± 48.6 (lb) | Body weight was 229.5 ± 47.6 (lb) (p = 0.49 vs. monthly care coordination telephone call) | Compared with the monthly care coordination telephone call group, the home telemonitoring group demonstrated significantly greater reductions in HbA1c |
| Kim and Oh, 2003, Korea 14 | Randomized controlled trial | 12 weeks, control group (n = 16), telemedicine group (n = 20) | HbA1c value was 8.8 ± 0.9% (p < 0.05 vs. baseline) | HbA1c value was 7.6 ± 1.0% (p < 0.05 vs. baseline) | No data | No data | The nurse telephone intervention can improve HbA1c |
| Khanna et al., 2014, Spanish 15 | Prospective, randomized, open-label trial with blinded endpoint assessment | 12 weeks, control group (n = 26), telemedicine group (n = 23) | Average change in HbA1c value was −0.3% | Average change in HbA1c value was −0.1% (p = 0.41 vs. control) | Average change in BMI value was −0.1 kg/m2 | Average change in BMI value was 0.4 kg/m2 (p = 0.21 vs. control) | There were no statistically or clinically significant differences between these 2 groups in changes in HbA1c |
| Cho et al., 2017, Korea 16 | A randomized, prospective open trial | 6 months, control group (n = 240), telemedicine group (n = 244) | Average change in HbA1c value was −0.11 ± 0.76%, Average change in Fasting blood glucose value was −6.86 ± 33.8 mg/dl, Average change in Postprandial glucose value was −1.65 ± 74.9 mg/dl | Average change in HbA1c value was −0.31 ± 0.7% (p < 0.05 vs. control), Average change in Fasting blood glucose value was −14 ± 40.2 mg/dl, Average change in Postprandial glucose value was −18.6 ± 71.4 (p < 0.05 vs. control) | Average change in BMI value was −0.2 ± 1.28 kg/m2, DTSQ scores were 26.7 ± 5.8 | Average change in BMI value was −0.33 ± 0.77 kg/m2, DTSQ scores were 27.9 ± 6.48 (p < 0.05 vs. control) | Internet-based health gateway device was effective in glucose control, including HbA1c reduction and postprandial glucose level. The intervention did not decrease, patient quality of life. |
| Welch et al., 2011, USA 17 | Randomized controlled trial | 12 months, control group (n = 18), telemedicine group (n = 21) | HbA1c value was 7.9 ± 1.4%, Average change in HbA1c value was −0.6 ± 1.1% | HbA1c value was 7.4 ± 1.4% (p = 0.26 vs. control), Average change in HbA1c value was −1.6 ± 1.4% (p = 0.01 vs. control) | BMI value was 33.8 ± 6.9 g/cm2 | BMI value was 32.6 ± 6.3 g/cm2 | The Comprehensive, Diabetes Management Program intervention was more effective than an attention control condition in helping patients meet evidence-based guidelines for diabetes care |
| Fortmann et al., 2017, USA 18 | A randomized, nonblinded, parallel-groups clinical trial | 6 months, control group (n = 59), telemedicine group (n = 50) | HbA1c value was 9.4 ± 2.0%, FBG value was 186.5 ± 68.5 mg/dl | HbA1c value was 8.5 ± 1.2% (p = 0.03 vs. control), FBG value was 161.3 ± 49.7 mg/dl | BMI value was 32.1 ± 6.6 kg/m2 (n = 58) | BMI value was 31.9 ± 5.4 kg/m2 | Dulce Digital group achieved a significantly greater reduction in HbA1c over time compared with usual care |
| Yang et al., 2020, Korea 19 | Randomized controlled trial | 3 months, control group (n = 94), telemedicine group (n = 145) | Average change in HbA1c value was −0.28% (95% CI: −0.42 to −0.13), Average change in FBG value was −2.41 mg/dl (95% CI: −13.64 to 8.82) | Average change in HbA1c value was −0.63% (95% CI: −0.77 to −0.50), Adjusted mean HbA1c difference to control was −0.30 (95% CI: −0.50 to −0.11) (p = 0.003), Average change in FBG value was −19.11 mg/dl (95% CI: −29.80 to −8.43), Adjusted mean FBG difference to control was −17.29 mg/dl (95% CI: −29.33 to −5.26) (p = 0.005) | BMI changed −0.41 (95% CI: −1.21 to 0.40) (kg/m2) from baseline | BMI changed −0.26 (95% CI: −0.40 to −0.11) (kg/m2) from baseline | The mobile phone–based glucose-monitoring and feedback system was effective in glycemic control when applied in primary care clinic settings. This system could be utilized effectively with diverse institutions and patients. |
| Wakefield et al., 2014, Missouri 20 | A single-center randomized controlled clinical trial | 3 months, control group (n = 53), telemedicine group (n = 41) | HbA1c value was 7.4 ± 0.18% (mean ± SE) | HbA1c value was 7.2 ± 0.2% (mean ± SE) | No data | No data | There were no statistically significant differences in HbA1c between the intervention and control participants |
| Egede et al., 2018, USA 21 | A randomized controlled trial | 12 months, control group (n = 47), telemedicine group (n = 43) | HbA1c value was 7.698% | HbA1c value was 6.875%, Difference between telemedicine and same room was −0.82 (p = 0.0061, 95% CI: −1.405, 0.241) | No data | No data | There was a significant main effect of the treatment group on the mean HbA1c value at the study end |
| Steventon et al., 2014, United Kingdom 22 | A large cluster randomized trial | 12 months, control group (n = 213), telemedicine group (n = 300) | The HbA1c value in the telemedicine group was lower than 0.21% control group (95% CI: 0.04% to 0.38%, p = 0.013) | No data | No data | Telehealth modestly improved glycaemic control in patients with type 2 diabetes over 12 months | |
| Duruturk and Özköslü, 2019, Turkey 23 | A double blind randomized controlled trial | 6 weeks, control group (n = 21), telemedicine group (n = 23) | HbA1c value was 7.92 ± 2.82% (p = 0.23 vs. baseline) | HbA1c value was 5.93 ± 1.46% (p < 0.05 vs. baseline) | No data | No data | Tele-rehabilitation intervention in Patients with T2DM could lead to improvements in glucose control |
| Cho et al., 2011, Korea 24 | A randomized controlled trial | 24 weeks, control group (n = 39), telemedicine group (n = 36) | HbA1c ⩽ 6.5% in both groups maintained their HbA1c at <6.5% (6.0 to 6.4% for the SAVE, group; 6.1 to 6.4% for the control group; p < 0.01 for both), HbA1c was also maintained in patients with baseline, HbA1c >6.5% (7.3 to 7.7% in the SAVE group, p = 0.062; 7.4 to 7.7% in the control group, p = 0.074) | No data | No data | The study showed the efficacy, and safety of the software for online communication in diabetes management | |
| Wakefield et al., 2011, USA 25 | Randomized controlled trial | 12 months, control group (n = 94), High−intensity group (n = 73), Low−intensity group (n = 79) | There was no significant difference between the change scores for the three groups [F(2, 1027) = 0.43, p = 0.65] | No data | No data | The intervention groups were comparable with the control group | |
| Kim et al., 2008, South Korea 26 | Quasi-experimental design | 12 months, control group (n = 16), telemedicine group (n = 18) | HbA1c value was 8.19 ± 0.54%, FBG was 175.8 ± 53.9 mg/dl, Two hours post−meal glucose was 264.7 ± 89.2 mg/dl | HbA1c value was 6.67 ± 0.77% (p < 0.05 vs. baseline), FBG was 149.6 ± 50.0 mg/dl, Two hours post−meal glucose was 169.7 ± 44.7 mg/dl (p < 0.05 vs. baseline) | No data | No data | This web-based intervention using SMS of personal cellular phone improved HbA1c in obese type 2 diabetic patients |
| Katula et al., 2022, USA 27 | Single-blind RCT | 12 months, control group (n = 300), telemedicine group (n = 299) | Average change in HbA1c value was −0.16% (95% CI: − 0.19 to − 0.12) | Average change in HbA1c value was −0.23% (95% CI: − 0.26 to −0.20), The between−group, difference in change in HbA1c was −0.08 (95% CI: −0.12 to −0.03, p < 0.025) | Body weight changed from baseline was −2.18 kg (95% CI: −2.97 to −1.39) | Body weight changed from baseline was −5.52 kg (95% CI: −6.30 to −4.75), The between−group, difference in change in BMI was −3.34 kg/m2 (95% CI: −4.39 to −2.29, p < 0.001) | Digital Diabetes Prevention Programs demonstrated clinical effectiveness and has significant potential for widespread dissemination and impact |
| Hu et al., 2021, China 28 | A randomized controlled trial | 6 months, control group (n = 70), telemedicine group (n = 72) | HbA1c value was 8.22 ± 2.04% | HbA1c value was 7.38 ± 1.67% (p = 0.008 vs. control) | No data | No data | After 6 months of follow-up, the telemedicine group, compared with the control group, showed significant decreases in HbA1c |
| Warren et al., 2018, Australia 29 | A prospective randomised controlled trial | 6 months, control group (n = 63), telemedicine group (n = 63) | HbA1c value was 8.1% [7.4−8.9] | HbA1c value was 7.5% [6.9−8.2], The reduction HbA1c values in the intervention group over time was significantly greater than in the control group (p < 0.01) | BMI value was 33.6 kg/m2 [29.5−38.4] | BMI value was 34.5 kg/m2, [30.3−39.6] | The Townsville Broadband Diabetes Telehealth trial showed that a positive effect on glycaemic control resulted from participation in a telemonitoring intervention when compared with usual care |
| Cho et al., 2011, Korea 30 | A randomized controlled design | 3 months, control group (n = 35), telemedicine group (n = 36) | HbA1c value was 7.8 ± 1.1 % (p = 0.11 vs. baseline) | HbA1c value was 7.5 ± 0.9% (p < 0.01 vs. baseline) | No data | No data | Compared with baseline, HbA1c was significantly reduced at three-month follow-up in the intervention group, but not in the control group |
| Jia et al., 2021, China 31 | A cluster randomized trial | 12 months | No data | Compared with usual care, the intervention led to an absolute improvement in the HbA1c control rate of 7.0% (95% confidence interval [CI] 4.0% to 10.0%) | No data | No data | After 1 year of application and follow-up, HbA1c was significantly reduced in primary care. |
| Trief et al., 2016, USA 32 | Randomized clinical trial | 12 months, diabetes education (n = 78), individual calls (n = 93), couples calls (n = 97) | No data | Significant decreased in HbA1c for all (12 months: cc −0.47%, ic −0.52%, de −0.57%), with no differences between arms | No data | CC showed significant improvement | Education alone was beneficial, but additional intervention is needed to achieve glycemic targets |
| Wayne et al., 2015, Canada 33 | Pragmatic randomized controlled trial | 6 months, control group (n = 49), telemedicine group (n = 48) | HbA1c value was 7.88 ± 1.17% | HbA1c value was 8.13 ± 1.27% | BMI value was 37.21 ± 8.22 kg/m2 (n = 36) | BMI value was 33.53 ± 6.80 kg/m2 (n = 39) | There was not statistically significant at 6 months because the control group’s mean HbA1c reduction improved between 3 and 6 months while the intervention group’s HbA1c level remained stable |
| Benson et al., 2019, USA 34 | Randomized controlled trial | 12 months, control group (n = 58), telemedicine group (n = 60) | HbA1c value was 7.7 ± 0.20% (mean ± SE) | HbA1c value was 7.4 ± 0.15 (mean ± SE) | BMI value was 35.7 ± 0.83 kg/m2 (mean ± SE) | BMI value was 37.9 ± 1.32 kg/m2 (mean ± SE) | The magnitude of change for most individual diabetes measures was somewhat similar in both groups |
| Hee-Sung, 2007, Korea 35 | A control group pretest–post-test design | 12 weeks, HbA1c <7.0% at baseline, control group (n = 11), telemedicine group (n = 13), HbA1c >= 7.0% at baseline, control group (n = 15), telemedicine group (n = 12) | HbA1c <7.0% at baseline: Average change in HbA1c value was 0.43 ± 0.53% (p = 0.034), HbA1c ⩾ 7.0% at baseline: Average change in HbA1c value was −0.22 ± 0.88% (p = 0.336) | HbA1c <7.0% at baseline: Average change in HbA1c value was −0.21 ± 0.57% (p = 0.201), HbA1c ⩾7.0% at baseline: Average change in HbA1c value was −2.15 ± 2.25% (p = 0.007) | No data | No data | There was a significant percentage change in a baseline-glycosylated haemoglobin ⩾ 7.0% for the intervention group; however, no significant change for the control group after 12 weeks. |
| Xu et al., 2020, Missouri 36 | A randomized controlled trial | 12 months, control group (n = 32), telemedicine group (n = 33) | Average change in HbA1c value was −0.03 (95% CI: −0.88 to 0.82), FBG increased by 13.0 mg/dL (95% CI: −47.67, to 73.69) | Average change in HbA1c value was −0.69 (95% CI: −1.41 to 0.02), FBG decreased by 21.6 mg/dL (95% CI: −37.56 to −5.639) | No data | No data | EpxDiabetes helps to reduce HbA1c in patients with uncontrolled T2DM |
| Lu et al., 2021, China 37 | A randomized controlled trial | 6 months, control group (n = 59), telemedicine group (n = 60) | HbA1c value was 8.17 ± 1.30% (p = 0.001 vs. baseline), FBG was 7.64 ± 1.13 mmol/L (p = 0.007 vs. baseline) | HbA1c value was 7.50 ± 0.96% (p = 0.001 vs. baseline, p = 0.002 vs. control), FBG was 7.31 ± 0.84 mmol/L (p = 0.001 vs. baseline, p = 0.077 vs. control) | No data | No data | The telemedicine group showed significantly lower HbA1c at 6 months compared with the control group |
| Anderson et al., 2010, USA 38 | A randomized controlled trial | 12months, control group (n = 117), telemedicine group (n = 94) | HbA1c value was 7.74% | HbA1c value was 7.66% | BMI value was 34.69 kg/m2 | BMI value was 34.50 kg/m2 | A clinic-based telephonic disease management support for underserved patients with diabetes did not improve clinical or behavioral outcomes at 1 year as compared to patients receiving usual care alone |
| Agarwal et al., 2019, Canada 39 | Multicenter pragmatic randomized controlled trial | 6 months, control group (n = 67), telemedicine group (n = 72) | HbA1c value was 8.41% (at 3 months) | HbA1c value was 8.22% (at 3 months) | No data | No data | The results showed no difference between intervention and control arms for the primary clinical outcome of glycemic control measured by HbA1c levels |
| Cho et al., 2009, Korea 40 | Randomized controlled trial | 3 months, Internet group (n = 34), Phone group (n = 35) | no control | HbA1c value was 6.9% (p < 0.01) in internet group, and 7.1% (p < 0.01) in phone group, Two−hour postprandial glucose levels also decreased significantly in both groups after three months (p = 0.001), but FBG levels did not change (p = 0.07) | No data | No data | Mobile, bidirectional communication between doctors and patients using the diabetes phone was as effective for glucose control |
| Quinn et al., 2016, USA 41 | Randomized controlled trial | 12 months, control group (n = 56), telemedicine group (n = 62) | HbA1c changed by−0.3% (95% CI = [−0.9, 0.3]) in older patients and −1.0% (95% CI = [−1.6, −0.4]) in younger group | HbA1c changed by−1.8% (95% CI = [−2.4, −1.1]) in older patients and −2.0% (95% CI = [−2.5, −1.5]) in younger group. The difference in 12−month changes (intervention − control) was −1.4% (95% CI = [−2.3, 0.6], p = 0.001) among older patients and −1.0% (95% CI =[−1.6, −0.4], p = 0.02) in younger group | No data | No data | Mobile PCS can be a useful intervention for those older patients with Type 2 diabetes, which contributed to a significant decrease in HbA1c over the 12-month study period, this could become mainstream in the coming years |
| Sun et al., 2019, China 42 | Randomized controlled trial | 6 months, control group (n = 47), telemedicine group (n = 44) | HbA1c value was 7.22 ± 0.87% | HbA1c value was 6.84 ± 0.76% (p < 0.05 vs. baseline, p = 0.02 vs control) | BMI value was 22.62 kg/m2 | BMI value was 23.8 kg/m2 | Mobile phone–based telemedicine apps help improve glycemic control in older Chinese patients with T2DM |
| Lim et al., 2016, Korea 43 | Randomized, controlled clinical trial | 6 months, control group − SMBG (n = 43), U−heathcare group (n = 42) | HbA1c value was 7.9 ± 1.2 % (p = 0.936 vs. baseline) | HbA1c value was 7.3 ± 0.9 % (p < 0.001 vs.baseline) | BMI value was 26.5 ± 3.7 kg/m2 (p = 0.110 vs. baseline) | BMI value was 25.7 ± 3.6 kg/m2 (p = 0.002 vs. baseline) | the patients using the multidisciplinary u-healthcare service showed better glycemic control with less hypoglycemia than those in the SMBG group |
| Tang et al., 2013, USA 44 | Randomized clinical trial | 12 months, control group (n = 193), telemedicine group (n = 186) | HbA1c value was 8.33 ± 1.81 % | HbA1c value was 8.1 ± 1.68 % (p = 0.133 vs.control) | No data | No data | INT patients achieved greater decreases in A1C at 6 months than UC patients, but the differences were not sustained at 12 months |
| Greenwood et al., 2015, USA 45 | Randomized clinical trial | 6 months, control group (n = 41), telemedicine group (n = 40) | HbA1c value was 7.46% | HbA1c value was 7.35% (p = 0.55 vs. control) | No data | No data | An eHealth model incorporating a complete feedback loop with telehealth remote monitoring and paired glucose testing with asynchronous data analysis significantly improved A1c levels compared to usual care. |
| Williams et al., 2012, Australia 46 | Randomised controlled trial | 6 month, control group (n = 60), telemedicine group (n = 60) | HbA1c value was 8.7% | HbA1c value was 7.9% | HRQ−mental was significantly different between the, two arms at six months (difference = 3.0, p = 0.007), No differences, were observed in HRQL−physical (p = 0.7) | TLC Diabetes program with clinically significant postintervention improvements in both glycaemic control and mental HRQL | |
| Ramadas et al., 2018, Malaysia 47 | Randomized clinical trial | 12 months, control group (n = 55), telemedicine group (n = 63) | HbA1c value was 8.4 ± 2.2% (p = 0.001 vs. baseline), FBG value was 7.7 ± 2.6 mmol/L (p = 0.117 vs. baseline) | HbA1c value was 8.5 ± 1.8% (p = 0.004 vs. baseline), FBG value was 7.9 ± 2.5 mmol/L (p = 0.015 vs. baseline) | No data | No data | E-intervention can be a feasible method for implementing chronic disease management in developing countries. |
| Egede et al., 2017, United States 48 | Randomized clinical trial | 6 months, control group (n = 44), telemedicine group (n = 41) | No data | The levels of HbA1c, in the TACM group were 0.99 points significantly lower compared to the usual care group (p = 0.024) | No data | No data | Participants in the techtechnology-assisted case management intervention group had significantly lower HbA1c levels at 6 months post randomization compared to participants in the usual care group. |
| Kim et al., 2016, China 49 | Randomized open-label, parallel group design | 6 months, control group (n = 90), telemedicine group (n = 92) | HbA1c value was 7.40 ± 1.30% (p < 0.001 vs. baseline), FBG was 7.8 ± 2.4 mmol/L (p = 0.058 vs. baseline), Post−prandial blood glucose was 12.0 ± 3.0 mmol/L (p = 0.088 vs. baseline), | HbA1c value was 6.70 ± 0.70% (p < 0.001 vs. baseline, p < 0.01 vs. control), FBG was 7.1 ± 1.6 mmol/L (p = 0.005 vs. baseline), Post−prandial blood glucose was 10.7 ± 2.0 mmol/L (p < 0.001 vs. baseline), | BMI value was 25.2 ± 3.6 kg/m2 (p = 0.564 vs. baseline) | BMI value was 25.7 ± 2.6 kg/m2 (p = 0.089 vs. baseline) | The Internet-based glucose monitoring system was effective in improving blood sugar levels among patients with diabetes |
| Goode et al., 2015, Australia 50 | A randomized trial | 24 months, control group (n = 131), telemedicine group (n = 181) | no data | Average back transformed from natural log HbA1c was:, − Low: 1.01% (95% CI: 0.96, 1.06), p = 0.69, − Medium: 0.98% (95% CI: 0.94, 1.03), p = 0.44, − High: 0.99 % (95% CI: 0.96, 1.03), p = 0.69 | no data | no data | There was no significant difference in the associations of call completion with any outcome |
| Jeong et al., 2018, Korea 51 | Randomized clinical trial | 24 weeks, control group (n = 101), telemonitoring group (n = 99), telemedicine group (n = 99) | HbA1c reduced 0.66 ± 1.03%. (p < 0.001 vs. baseline) | HbA1c reduced 0.66% ± 1.09% in telemonitoring group, 0.81%± 1.05% in the telemedicine group (p < 0.001 vs. baseline) | No data | No data | Telehealthcare was as effective as conventional care at improving glycemia in patients with type 2 diabetes without serious adverse effects. |
| Nagrebetsky et al., 2013, United Kingdom 52 | Feasibility trial | 6 months, control group (n = 7), telemedicine group (n = 7) | The median (IOR) change in HbA1c was −0.5% [−1.2% to 0.6%] | The median (IOR) change in HbA1c was −0.9% [−1.9% to 0%] | No data | No data | Self-titration of oral glucose-lowering medication in type 2 diabetes with self-monitoring and remote monitoring of blood glucose levels by clinical staff was feasible in primary care and may improve clinical outcomes |
| Wild et al., 2016, United Kingdom 53 | Randomized clinical trial | 9 months, control group (n = 139), telemedicine group (n = 146) | HbA1c value was 8.4 ± 1.3% | HbA1c value was 7.9 ± 1.4%., The absolute mean difference in HbA1c between groups was −0.51% (p = 0.007) | No data | No data | Supported telemonitoring resulted in clinically important improvements in control of glycaemia in patients with type 2 diabetes in family practice |
| de Vasconcelos et al., 2018, Brazil 54 | Randomized clinical trial | 24 weeks, control group (n = 15), telemedicine group (n = 16) | HbA1c value increased from 6.9 ± 1.31% to 7.33 ± 1.73% | HbA1c value decreased from 8.0 ± 2.14% to 7.21 ± 1.19% | BMI value was 30.23 ± 5.29 kg/m2 | BMI value was 29.96 ± 6.04 kg/m2 (p = 0.92 vs. control) | Telecoaching is an effective tool for diabetes management |
| Rasmussen et al., 2016, Denmark 55 | Randomised controlled trial | 6 months, control group (n = 22), telemonitoring group (n = 18) | Average change in HbA1c value was −10.6% (65 to 55 mmol/mol), Average change in blood glucose levels value was −13.1% (10.3 to 8.7 mmol/l) | Average change in HbA1c value was −14.6% (76 to 61 mmol/mol, p=0.016 vs. control), Average change in blood glucose levels value was −17.6% ( 11.7 to 9.7 mmol/l, p=0.015 vs. control) | Average change in Weight value was 1.7 kg (88 to 86.7) | Average change in Weight value was 0.6 kg (99.7 to 99.1, p=0.023 vs. control) | In the direct comparison of home video consultations vs standard outpatient treatment in type 2 diabetes mellitus, telemedicine was a safe and available option with favourable outcomes after six months treatment. |
| Rodríguez-Idígoras et al., 2009, Spain 56 | Randomized controlled parallel-group trial | 12 months, control group (n = 151), telemedicine group (n = 146) | HbA1c value was 7.35 ± 1.38% (p = 0.303 vs. baseline) | HbA1c value was 7.4 ± 1.43% (p = 0.027 vs. baseline) | No data | No data | A teleassistance system using real-time transmission of blood glucose results with an option to make telephone consultations is feasible in the primary care setting as a support tool for family physicians in their follow-up of type 2 diabetes patients. |
| von Storch et al., 2019, Germany 57 | Prospective study | 3 months, control group (n = 55), telemedicine group (n = 60) | HbA1c value was 6.95 ± 1.02 % (p = 0.465 vs. baseline) (n = 54) | HbA1c value was 6.58 ± 0.723 % (p < 0.05 vs. baseline, p < 0.05 vs control) (n = 52) | BMI value was 29.39 ± 4.37 kg/m2 (p < 0.05 vs. baseline) (n =55) | BMI value was 31.8 ± 6.98 kg/m2 (p = 0.569 vs. baseline) (n = 53) | HbA1c values of the intervention group participants were significantly reduced in comparison to those in the control group after 3 months. |
| Lee et al., 2020, Malaysia 58 | Cluster-randomized controlled trial | 52 weeks, control group (n = 104), telemedicine group (n = 104) | HbA1c value was 8.70% | HbA1c value was 8.69%( p = 0.226 vs. control) | No data | No data | The addition of telemedicine in replacement of self-monitoring in diabetes care had limited clinical benefits in improving glycemic control |
| Lee et al., 2017, Malaysia 59 | Cluster-randomised controlled trial | 12 weeks, control group (n = 40), telemedicine group (n = 45) | HbA1c value was 8.55 ± 1.86% (p = 0.33 vs. baseline) | HbA1c value was 7.62 ± 1.61% (p < 0.01 vs. baseline) | BMI value was 30.49 ± 5.11 kg/m2 (p = 0.02 vs. baseline), EuroQoL−5D was 0.81 ± 0.26 | BMI value was 29.42 ± 5.92 kg/m2 (p = 0.01 vs. baseline), EuroQoL−5D was 0.87 ± 0.11 | Mean HbA1c levels in the telemonitoring group improved by 1.07% compared with 0.24% for usual care group at the end of the study. Diabetes education was also found to be able to improve the patients’ quality of life at the end of the study. |
| Dario et al., 2017, Italy 60 | Randomized controlled trial | 12 months, control group (n = 78), telemedicine group (n = 168) | Average change in HbA1c was −0.27 ± 0.99% | Average change in HbA1c was −0.26 ± 0.92% (p = 0.76 vs. control) | No data | No data | There was no statistically, significant difference in HbA1c between the two groups |
| Egede et al., 2017, USA 61 | Randomized controlled trial | 12 months, n = 255 | HbA1c at 12 months for the intervention groups did not differ significantly from that of the control group (knowledge: 0.49, p = 0.123; skills: 0.23, p = 0.456; combined: 0.48, p = 0.105). | Did not show any significant improvement in HRQoL in both groups | Combined education and skills training did not achieve greater reductions in glycemic control at 12 months compared to the control group, education alone, or skills training alone. | ||
| Bujnowska-Fedak et al., 2011, Poland 62 | Randomized clinical trial | 6 months, control group (n = 48), telemedicine group (n = 47) | HbA1c value was 7.43 ± 1.49 % | HbA1c value was 7.37 ± 1.27% (p = 0.72 vs. control) | BMI value was 26.4 ± 6.1 kg/m2 | BMI value was 24.8 ± 6.9 kg/m2 (p = 0.38 vs. control), The difference in QoL between the two groups was not statistically significant | Telehome monitoring is an effective tool in controlling type 2 diabetes in a primary care setting |
| Arora et al., 2014, United States 63 | Randomized controlled trial | 6 months, control group (n = 64), telemedicine group (n = 64) | Hb A1C decreased by 0.60% | Hb A1C decreased by 1.05% (p = 0.230 vs. control) | No data | No data | The TExT-MED program did not result in a statistically significant improvement in HbA1c. |
| Kardas et al., 2016, Poland 64 | A feasibility prospective parallelarm randomized controlled trial | 6 weeks, control group (n = 30), telemedicine group (n = 30) | Average change in FBG (FBG) (mg/dL) was 11.7 ± 36.1 (148.9 ± 43.5 to 137.2 ± 36.6) (p > 0.05), Average change in HbA1c (%) was 0.01 ± 0.36 (6.84 ± 0.98 to 6.78 ± 0.92) (p > 0.05) | Average change in FBG (FBG) (mg/dL) was 9.5 ± 22.5 (145.2 ± 40.7 to 135.7 ± +61.6) (p < 0.05), Average change in HbA1c (%) was 0.04 ± 0.52 (6.78 ± 1.10 to 6.75 ± 0.95) (p > 0.05) | Health related quality of life, as assessed with cumulative utility measure, improved significantly in COMMODITY12 system users (p < 0.05) | mHealth solution was well accepted by type 2 diabetes patients taking part in clinical trial, leading to several clinical benefits, and improved quality of life. | |
| McFarland et al., 2012, USA 65 | Nonrandomized, parallel, control group study | 6 months, control group (n = 67), telemedicine group (n = 36) | Average change in HbA1c (%) was 2.1 ± 1.7 (9.0 ± 1.5 to 6.9 ± 1.0) | Average change in HbA1c (%) was 1.6 ± 1.2 (9.1 ± 1.6 to 7.5 ± 1.1) (p = 0.1987 vs. control) | No data | No data | No statistically significant difference was demonstrated with respect to change in A1C from baseline to 6 months |
| Hansen et al., 2017, Denmark 66 | Cross-sectional randomized controlled trial | 8 months, control group (n = 77), telemedicine group (n = 69) | Average change in HbA1c was 0.18% (p = 0.22 vs. baseline) | Average change in HbA1c was 0.69% (p < 0.000001 vs. baseline) | No data | No data | Video consultations preceded by uploading relevant measurements can lead to clinically and statistically significant improvements in glycemic control among patients who have not responded to standard regimens |
| Zhou et al., 2014, China 67 | Prospective randomized study | 3 months, control group (n = 55), telemedicine group (n = 53) | HbA1c decreased from 8.22±1.58 to 7.60±1.57%.(p = 0.001 vs. baseline), FBG decreased from 8.73±2.60 to 8.02±2.38 mmol/L (p = 0.007 vs. baseline) | HbA1c decreased from 8.44±1.58 to 6.84±1.20% (p < 0.001 vs. baseline), FBG decreased from 8.73±2.61 to 7.06±1.49 mmol/L (p < 0.001 vs. baseline) | BMI value was 23.75±2.93 kg/m2 | BMI value was 24.72±3.36 kg/m2 | Telemedicine system can provide a tighter glycemic control for the treatment of Patients with T2DM |
| Luley et al., 2011, Germany 68 | Randomized clinical trial | 6 months, control group (n = 35), telemedicine group (n = 33) | HbA1c increased by 0.2% (p = 0.053 vs. baseline) | HbA1c decreased by 0.8% (p < 0.0125 vs. basseline) | BMI decreased by 0.1 kg/m2 (no significant) | BMI decreased by 4.1 kg/m2 (p < 0.0125 vs. basseline) | The ABC program effectively lowers body weight, Hb1Ac in patients with type 2 diabetes. |
| Hsu et al., 2016, USA 69 | A randomized controlled study | 12 weeks, control group (n = 16), telemedicine group (n = 19) | Average change in HbA1c was 2.0 ± 2.0% | Average change in HbA1c was 3.2 ± 1.5% (p = 0.048 vs. control) | No data | No data | Mobile health technology could be an effective tool in sharing data, enhancing communication, and improving glycemic control while enabling collaborative decision making in diabetes care. |
| Kleinman et al., 2017, India 70 | A randomized clinical trial | 6 months, control group (n = 46), telemedicine group (n = 44) | Average change in HbA1c was −0.8 ± 1.6%, Average change in FBS was −23.5 ± 70.0 mg/dL | Average change in HbA1c was −1.5 ± 1.1% (p = 0.02 vs. control), Average change in FBS was −32.6 ± 66.4 mg/dL (p = 0.55 vs. control) | Average change in BMI was 0.1 ± 1.1 kg/m2 | Average change in BMI was −0.1 ± 1.0 kg/m2 (p = 0.53 vs. control) | This tool could be an effective way to expand access to quality chronic disease care and improve outcomes |
| Orsama et al., 2013, Finland 71 | A randomized controlled trial | 10 months, control group (n = 24), telemedicine group (n = 24) | Average change in HbA1c was 0.036% | Average change in HbA1c was −0.4% (p = 0.022 vs. control) | Average change in weight was 0.4 kg | Average change in weight was −2.1 kg (p = 0.021 vs. control) | Results showed that the automated feedback intervention had significant effects on HbA1c and on weight, which declined reliably in intervention compared with control participants with type 2 diabetes or type 2 diabetes and hypertension. |
| Kim et al., 2007, Korea 72 | A randomized controlled trial | 12 weeks, control group (n = 26), telemedicine group (n = 25) | Average change in HbA1c was 0.07% (7.59 ± 1.09 to 7.66 ± 0.91), 2HPMG was 13.77 ± 4.2 mmol/l | Average change in HbA1c was −1.15% (8.09 ± 1.72 to 6.94 ± 1.04) (p < 0.05 vs. baseline), 2HPMG was 9.5 ± 4.4 mmol/l (p < 0.05 vs. baseline) | No data | No data | This educational intervention using the Internet and an SMS by cellular phone improved levels of HbA1c and 2HPMG |
| Bender et al., 2017, USA 73 | A randomized controlled trial | 6 months, control group (n = 23), telemedicine group (n = 22) | Average change in HbA1c was −0.3% (7.4 ± 0.93 to 7.1 ± 1.2), Average change in Fasting glucose was −5.4 mg/dL (137.4 ± 30.1 to 132.0 ± 33.0) | Average change in HbA1c was −0.3% (7.4 ± 0.82 to 7.1 ± 0.98), Average change in Fasting glucose was −4.3 mg/dL (133 ± 20.8 to 128.7 ± 30.6) | Average change in BMI was −0.1 kg/m2 (31.5 ± 5.1 to 30.5 ± 5.6), Average change in weight was −2.4 kg (78.8 ± 18.6 to 76.4 ± 19.8) | Average change in BMI was −0.3 kg/m2 (28.5 ± 3.6 to 27.5 ± 3.6), Average change in weight was −1.6 kg (72.6 ± 10.8 to 70.8 ± 11.0) | Improvements in fasting glucose and HbA1c give promise to the efficacy of the PilAm Go4Health mHealth intervention to enhance diabetes self-management. |
| Blackberry et al., 2013, Australia 74 | Prospective, cluster randomised controlled trial | 18 months, control group (n = 222), telemedicine group (n = 220) | Average change in HbA1c was −0.22% (8.13 ± 1.34 to 7.91 ± 1.42) | Average change in HbA1c was −0.13% (7.98 ± 1.22 to 7.85 ± 1.24) (p = 0.84 vs. control) | Average change in weight was 0.5 kg (92.2 ± 20.5 to 92.7 ± 21.0) | Average change in weight was −0.3 kg (91.0 ± 19.5 to 90.7 ± 21.0) (p = 0.89 vs. control) | At 18 months’ follow-up the effect on glycaemic control did not differ significantly between the intervention and control groups |
| Borhani et al., 2013, Kerman 75 | A quasi-experimental study | 3 months, control group (n = 25), telemedicine group (n = 25) | Average change in HbA1c was −0.16% (9.38 ± 1.53 to 9.14 ± 1.59), Average change in FBS was −26.34 mg/dl (188.38 ± 54.20 to 162.04 ± 47.66), Average change in PPG was −16.48 mg/dl (247.43 ± 74.06 to 263.91 ± 69.84) | Average change in HbA1c was −1.83% (9.98 ± 1.34 to 8.15 ± 0.97) (p < 0.001 vs. baseline), Average change in FBS was −38 mg/dl (173.56 ± 54.77 to 135.12 ± 37.54), Average change in PPG was −54.92 mg/dl (257.64 ± 67.48 to 202.72 ± 45.21) (p < 0.001 vs. baseline) | Average change in BMI was −0.77 (30.69 ± 6.67 to 29.92 ± 9.05) | Average change in BMI was −0.2 (27.93 ± 4.84 to 28.13 ± 4.88) | The results showed that phone follow-ups can improve the process of self-care and the control of Glycemic index in patients with type II diabetes |
| Faridi et al., 2008, USA 76 | A pilot controlled trial | 3 months, control group (n = 15), telemedicine group (n = 15) | Average change in HbA1c was 0.3 ± 1.0% (p = 0.3813 vs. baseline) | Average change in HbA1c was −0.1 ± 0.3% (p = 0.1534 vs. baseline) | Average change in BMI was 2.2 ± 7.7 kg/m2, Average change in weight was −3.1 ± 7.5 lbs | Average change in BMI was 0.0 ± 0.9 kg/m2, Average change in weight was −0.1 ± 5.4 lbs | The results indicate the intervention had a positive impact on some clinical outcome and self-efficacy |
| Hallberg et al., 2018, USA 77 | An open-label, nonrandomized, controlled, before-and-after 1-year study | 1 year, control group (n = 72), telemedicine group (n = 204) | Average change in HbA1c was 0.20 ± 1.35)% (p = 0.21 vs. baseline) | Average change in HbA1c was − 1.29 ± 1.32% (p < 0.05 vs. baseline) | Average change in weight was 0.04 ± 5.94 kg (p = 0.95 vs. baseline) | Average change in weight was − 14.24 ± 10.29 (p < 0.05 vs. baseline) | These results demonstrate that a novel metabolic and continuous remote care model can support adults with T2D to safely improve HbA1c, weight |
| Holmen et al., 2014, Norway 78 | A 3-arm prospective randomized controlled trial | 12 months, control group (n = 41), FTA (n = 49), FTA−HC (n = 40) | Average change in HbA1c was −0.16% (95% CI: −0.50, 0.1) | FTA: Average change in HbA1c was −0.31% (95% CI: −0.67, 0.05), FTA−HC: Average change in HbA1c was −0.15% (95% CI: −0.58, 0.29) | Average change in weight was −1.2 kg (95% CI: –2.75, 0.54) | FTA: Average change in weight was −1.3 kg (95% CI: –3.05, 0.43), FTA−HC: Average change in weight was −0.7 kg (95% CI: –2.29, 0.84) | Although HbA1c level declined in all groups, the change did not differ significantly between either of the intervention groups and the control group after 1 year |
| Lim et al., 2011, Korea 79 | A randomized controlled trial | 6 months, control group (n = 48), u−healthcare (n = 49), SMBG (n = 47) | HbA1c decreased from 7.9 ± 0.8% to 7.8 ± 1.0% (p = 0.274) | HbA1c level was significantly decreased from 7.8 ± 1.3% to 7.4 ± 1.0% (p < 0.001) in the u−healthcare group and from 7.9 ± 1.0% to 7.7 ± 1.0% (p = 0.020) in the SMBG group | BMI was 25.8 ± 3.4 kg/m2 (p = 0.005 vs. baseline) | u−healthcare group: BMI was 24.4 ± 2.5 kg/m2 (p = 0.009 vs. baseline), SMBG group: BMI was 25.0 ± 3.2 kg/m2 (p = 0.303 vs. baseline) | The CDSS-based u-healthcare service achieved better glycemic control with less hypoglycemia than SMBG and routine care and may provide effective and safe diabetes management in the elderly diabetic patient |
| Odnoletkova et al., 2016, Belgium 80 | A parallel-group, randomized controlled trial | 18 months, control group (n = 246), telemedicine group (n = 240) | HbA1c level was 7.0 ± 1.1% | HbA1c level was 6.9 ± 1.0% (p = 0.046 vs. control) | BMI was 30.4 ± 5.1 kg/m2 (n = 246) | BMI was 29.9 ± 5.0 kg/m2 (p = 0.602 vs. control) (n = 238) | Twelve months after the intervention completion, there were sustained improvements in glycaemic control |
| Quinn et al., 2011, USA 81 | A cluster-randomized clinical trial | 12 months, control group (n = 51), CO group (n = 21), CPP group (n =21), CPDS group (n = 56) | Average change in HbA1c was −0.7% (95% CI: −1.1, −0.3) | CO: Average change in HbA1c was −1.6 (95% CI: −2.3, −1.0), CPP: Average change in HbA1c was −1.2 (95% CI: −1.8, −0.5), CPDS: Average change in HbA1c was −1.9 (95% CI: −2.3, −1.5) | No data | No data | The mean declines in glycated hemoglobin were 1.9% in the maximal treatment group and 0.7% in the usual care group, a difference of 1.2% (p = 0.001) over 12 months |
| Rothman et al., 2005, USA 82 | A randomized controlled trial | 12 months, control group (n = 95), telemedicine group (n = 99) | Average change in HbA1c was −1.6% | Average change in HbA1c was −2.5% (difference, 0.8%; 95% CI: 0% to 1.7%; p <, 0.05 vs. control) | No data | No data | The comprehensive disease management program reduced HbA1c levels among patients with type 2 diabetes and poor glycemic control. |
| Varney et al., 2014, Australia 83 | A random controlled trial | 12 months, control group (n = 36), telemedicine group (n = 35) | HbA1c level was 8.4% (95% CI: 8.0, 8.7) | HbA1c level was 8.2% (95% CI: 7.9, 8.6) | BMI was 31.7 kg/m2 | BMI was 31.6 kg/m2 | Telephone coaching improved glycaemic control and adherence to complication screening in people with type 2 diabetes, for the duration of its delivery, but these effects were not maintained on withdrawal of the intervention |
| Waki et al., 2014, Japan 84 | A nonblinded randomized controlled study | 3 months, control group (n = 27), telemedicine group (n = 27) | Average change in HbA1c was 0.1 %, Average change in FBS was 16.9 mg/dl | Average change in HbA1c was −0.4% (p = 0.015 vs. control), Average change in FBS was −5.5 (p = 0.019 vs. control) | BMI was 27.1 ± 7.5 kg/m2 | BMI was 25.9 ± 5.9 kg/m2 | HbA1c and FBS values declined significantly in the DialBetics group |
| Wang et al., 2019, China 85 | A random controlled trial | 6 months, control group (n = 60), telemedicine group (n = 60) | HbA1c value was 7.92 ± 2.15% (p < 0.05 vs. baseline), FBG was 7.96 ± 3.63 mmol/l (p < 0.05 vs. baseline), Two hours post−meal glucose was 12.67 ± 3.42 mmol/l (p < 0.05 vs. baseline) | HbA1c value was 7.12 ± 2.01% (p < 0.05 vs. baseline and control), FBG was 6.58 ± 3.02 mmol/l (p < 0.05 vs. baseline and control), Two hours post−meal glucose was 10.43 ± 3.12 mmol/l (p < 0.05 vs. baseline and control) | No data | No data | After the intervention, levels of FPG, 2-hour postprandial blood glucose, and HbA1c were lower in the test group than in the control group; the differences were statistically significant |
| Kusnanto et al., 2019, Indonesia 86 | A randomized experimental study | 3 months, control group (n = 15), telemedicine group (n = 15) | HbA1c value was 7.91 ± 0.88% (p = 0.208 vs. baseline) | HbA1c value was 7.64 ± 1.29% (p = 0.001 vs. baseline, p = 0.005 vs. control) | No data | No data | The HbA1c values in the experimental group was significant and was not significant in the control group. Independent t-tests also showed significant value comparison between two groups |
| Yoo et al., 2009, Korea 87 | A randomized, controlled clinical trial | 12 months, control group (n = 54), telemedicine group (n = 57) | HbA1c value was 7.6 ± 1.0% (p = 0.033 vs. baseline) | HbA1c value was 7.1 ± 0.8% (p < 0.001 vs. baseline) | BMI was 25 ± 3.3 kg/m2 | BMI was 25.1 ± 3.5 kg/m2 | After 12 weeks, there were significant improvements in HbA1c in the intervention group compared with the control group |
| Meigs et al., 2003, USA 88 | A group randomized controlled trial | 12 months, control group (n = 291), telemedicine group (n = 307) | Average change in HbA1c was 0.14% | Average change in HbA1c was −0.23% (p = 0.09 vs. control) | No data | No data | Web-based patient-specific decision support has the potential to improve evidence-based parameters of diabetes care |
| Tutino et al., 2017, China 89 | A multicentre randomized nonblinded study | 12 months, DIAMOND group (n = 1176), JADE group (n = 1383) | No data | DIAMOND: Average change in HbA1c was −0.69% (95% CI: −0.81, −0.57), JADE: Average change in HbA1c was −0.62% (95% CI: −0.73, −0.50) | No data | No data | Integrated care augmented by information technology improved cardiometabolic control, with additional nurse contacts reducing the default rate and enhancing self-care |
| Graziano et al., 2009, USA 90 | A randomized controlled trial | 3 months, control group (n = 58), telemedicine group (n = 61) | Average change in HbA1c was −0.767 ± 1.14% | Average change in HbA1c was −0.834 ± 1.09% (p = 0.84 vs. baseline) | No data | No data | there were no significant differences between the telephone and control groups on mean change HbA1c level |
| Middleton et al., 2021, Australisa 91 | A randomized controlled trial | 12 months, control group (n = 15), telemedicine group (n = 20) | HbA1c value was 6.6 ± 1.7% | HbA1c value was 7.1 ± 1.1% (p = 0.37 vs. control) | BMI was 31.8 ± 5.8 kg/m2 | BMI was 30.4 ± 8.4 kg/m2 (p = 0.57 vs. control) | There was no difference in mean HbA1c between groups |
| Smith et al., 2008, USA 92 | A randomized controlled trial | 12 months, control group (n = 271), telemedicine group (n = 342) | HbA1c value was 6.7% (range: 4.8−13.7) | HbA1c value was 6.7% (range: 4.5−12.8) | No data | No data | Specialty telemedicine did not significantly enhance the value of CCM (the chronic care model) in primary care |
| Farmer et al., 2021, UK 93 | Two parallel-arm, individually randomised controlled trial | 12 months, control group (n = 511), telemedicine group (n = 510) | Average change in HbA1c was −13.0 ± 31.27 mmol/mmol | Average change in HbA1c was −12.5 ± 30.72 mmol/mmol (p = 0.537 vs. control) | No data | No data | Whilst SMS text messages do not lead to improved glycaemia in these low-resource settings |
| Vinitha et al., 2019, India 94 | A multicentric, randomised controlled trial | 24 months, control group (n = 122), telemedicine group (n = 126) | HbA1c value was 7.6 ± 1.3% (p < 0.0001), FBG was 142.4 ± 37.1 mg/dl (p < 0.0001) | HbA1c value was 7.2 ± 1.2% (p < 0.0001), FBG was 128.9 ± 32.2 mg/dl (p < 0.0001) | BMI was 27.7 ± 4.6 kg/m2 (n.s) | BMI was 27.2 ± 4.4 kg/m2 (n.s) | At 24 months, both groups showed significant reduction in blood pressure and glycaemic variables in comparison to the baseline values |
| Peimani et al., 2016, Iran 95 | A three-arm randomized controlled trial | 3 months, control group (n = 50), Tailored−SMS group (n = 50), Non−tailored−SMS group (n =50) | HbA1c value was 7.55 ± 1.44% (p = 0.847), FBS was 165.32 ± 57.85 mg/dl (p = 0.850), | Tailored−SMS group:, HbA1c value was 7.06 ± 1.31% (0.050 vs. baseline), FBS was 152.54 ± 81.09 mg/dl (p = 0.003 vs. baseline), Non−tailored−SMS group:, HbA1c value was 7.26 ± 1.32% (p = 0.075 vs. baseline), FBS was 147.82 ± 47.27 mg/dl (p = 0.026 vs. baseline) | BMI was 28.21 ± 5.15 kg/m2 (p = 0.045) | Tailored−SMS group: BMI was 27.14 ± 5.51 kg/m2 (p < 0.001 vs. baseline), Non−tailored−SMS group: BMI was 26.90 ± 4.57 kg/m2 (p = 0.002 vs. baseline) | Although there were significant differences in the outcomes between the intervention groups and the control one, the differences between intervention groups (tailored and nontailored SMS groups) were not significant |
| Schillinger et al., 2009, USA 96 | A three-arm practical clinical trial | 12 months, control group (n = 103), ATSM group (n = 101), GMV group (n =96) | HbA1c value was 9.0 ± 2.2% | ATSM: HbA1c value was 8.7 ± 1.9%, GMV: HbA1c value was 9.0 ± 2.0% | No data | No data | Glycemic control improved across all three arms, but there were no statistically significant differences in A1C change between three groups |
| Kim et al., 2014, Korea 97 | Clinical trial | 3 months, control group (n = 35), telemedicine group (n = 35) | HbA1c value was 7.7±0.7% (p =0.973 vs. baseline) | HbA1c value was 7.5 ± 0.7% (p = 0.077 vs. baseline) | BMI was 24.3±3.1 kg/m2 (p = 0.066 vs. baseline) | BMI was 25.0±3.4 kg/m2 (p = 0.804 vs. baseline) | Both the smartphone group and the control group showed a tendency towards a decrease in the HbA1c level after 3 months |
| Iljaž et al., 2017, Slovenia 98 | A randomized controlled trial | 6 months, control group (n = 54), telemedicine group (n = 53) | HbA1c value was 6.7 ± 1.5% | HbA1c value was 6.4 ± 0.9% (p < 0.05 vs. baseline) | BMI was 31.8 ± 5.1 kg/m2 | BMI was 32.0 ± 4.7 kg/m2 | The significant reduction of HbA1c values in the interventional group confirmed the application’s potential to improve the regulation of DM type 2 in patients who are not using insulin. |
| Kwon et al., 2004, Korea 99 | A randomized controlled trial | 3 months, control group (n = 50), telemedicine group (n = 51) | Average change in HbA1c was 0.33% | Average change in HbA1c was −0.54% (p < 0.05 vs. baseline) | no data | No data | The intervention group showed a marked decrease in HbA1c levels after 12 weeks of follow-up versus the baseline levels, whereas the control group showed slightly increased HbA1c levels after the same period |
| Lee et al., 2017, Korea 100 | A subanalysis of clinical trial | 6 months, control group (n = 91), Infrequent users (n = 54), Frequent users (n = 53) | Average change in HbA1c was −1.8 ± 1.7% | Infrequent users: Average change in HbA1c was −1.5±1.5%, Frequent users: Average change in HbA1c was −2.4 ± 1.6% (p < 0.05 vs. control and infrequent users) | Average change in BMI was −0.02 ±1.2 kg/m2 | Infrequent users: Average change in BMI was 0.0±1.5 kg/m2, Frequent users: Average change in BMI was −0.1±2.4 kg/m2 | Initial active engagement in self-monitoring with a telemonitoring device could provide incremental improvement of glycemic control over 6 months |
| Kim et al., 2010, Korea 101 | Clinical trial | 12 weeks, control group (n = 45), telemedicine group (n = 47) | HbA1c value was, 7.8 ± 0.8% | HbA1c value was 7.4 ± 0.7% (p = 0.023 vs. control) | Body weight increased 2.2 ± 2.8 kg | Body weight increased 2.4 ± 3.0 kg (p = 0.653 vs. control) | The significant decrease in HbA1C was accomplished with a minimal incidence of hypoglycemia and a small increase in body weight |
| Song et al., 2009, Korea 102 | A randomized two-group pretest/posttest experimental study | 12 weks, control group (n = 24), telemedicine group (n = 25) | HbA1c value was 8.6 ± 1.3% | HbA1c value was 7.1 ± 1.2% (p < 0.05 vs. baseline) | No data | No data | hese findings indicate that the DOIMP can improve HbA1c levels in patients with type 2 diabetes |
| McKay et al., 2002, USA 103 | A randomized design study | 3 months | Information−only condition: HbA1c value was 7.37 ± 1.49% (n= 33) | Peer support condition: HbA1c value was 7.59 ± 1.66% (n = 30), Personal self−management coach condition: HbA1c value was 7.73 ± 1.42% (n = 37), Combined condition: HbA1c value was 7.28 ± 1.28% (n = 33) | No data | No data | There was no significant between-condition differences |
| Cho et al., 2006, Korea 104 | A randomized controlled trial | 30 months, control group (n = 40), telemedicine group (n = 40) | HbA1c value was 7.4 ± 1.3% | HbA1c value was 6.7 ± 0.9% (p < 0.05 vs. baseline) | No data | no data | The mean A1C were significantly lower in the intervention group than in the control group |
| Eakin et al., 2013, Australia 105 | A two-arm randomized controlled trial | 6 months, control group (n = 151), telemedicine group (n = 151) | HbA1c value was 7.5 ± 1.6% | HbA1c value was 7.5 ± 1.7% | Weight value was 95.3 ± 20.9 kg | Weight value was 93.3 ± 19.0 kg | The intervention effects showed, relative to usual care, that the intervention group achieved more weight loss. there was no substantial or statistically significant difference, between groups in HbA1c |
| Agboola et al., 2016, USA 106 | A randomized controlled trial | 6 months, control group (n = 62), telemedicine group (n = 64) | Average change in HbA1c was −0.21% | Average change in HbA1c was −0.43% (p =0.29 vs. control) | No data | No data | Personalized text messaging can be used to improve outcomes in patients with T2DM by employing optimal patient engagement measures |
| Glasgow et al., 2012, USA 107 | A patient-randomized practical effectiveness trial | 12 months | HbA1c value was 8.04 ± 0.14% | HbA1c value was 8.16 ± 0.09% | BMI was 34.8 ± 0.6 kg/m2 | BMI was 34.6 ± 0.4 kg/m2 | The Internet intervention meets the reach and feasibility criteria for a potentially broad public health impact |
| Ralston et al., 2009, USA 108 | A pilot randomized trial | 12 months, control group (n = 35), telemedicine group (n = 39) | Average change in HbA1c was 0.2% | Average change in HbA1c was −0.9% (p < 0.01 vs. control) | No data | No data | GHb declined significantly in the intervention group compared with the usual care group |
| Noh et al., 2010, Korea 109 | A randomized controlled trial | 6 months, control group (n = 20), telemedicine group (n = 20) | Average change in HbA1c was −0.49% (p = 0.257 vs. baseline) | Average change in HbA1c was −1.53% (p = 0.031 vs. baseline) | Average change in BMI was 0 kg/m2 (p = 1 vs. baseline) | Average change in BMI was 0.65 kg/m2 (p = 0.657 vs. baseline) | The improvement in A1C for the intervention group, compared with no difference in the control group after 6 months |
| Murray et al., 2017, England 110 | A multicentre, two-arm individually randomised controlled trial | 12 months, control group (n = 163), telemedicine group (n = 155) | Average change in HbA1c was 0.16 ± 0.07% | Average change in HbA1c was −0.08 ± 0.07% (p = 0.014 vs. control) | Average change in BMI was −0.04 ± 0.2 kg/m2 | Average change in BMI was 0.12 ± 0.2 kg/m2 (p = 0.498 vs. control) | Participants in the intervention group had lower HbA1c than those in the control |
| Bingham et al., 2021, USA 111 | A retrospective study | 3 months, (n = 444) | No data | HbA1c value was 7.1% [4.5−13.6] (p = 0.009 vs. baseline) | No data | No data | There was a significant difference between median HbA1c values pre- and postcomprehensive medication review |
| Michaud et al., 2020, Nebraska 112 | Retrospective observational study | 3 months, (n = 1103) | No data | HbA1c value was 7.1 ± 1.5% (p < 0.001 vs. baseline) | No data | No data | There were significant differences in HbA1C at baseline and HbA1C at the end of remote patient monitoring (RPM) |
| Kesavadev et al., 2012, India 113 | A retrospective cohort study | 6 months, (n = 1000) | No data | HbA1c value was 6.3 ± 0.6%, HbA1c decreased by 2.2% (p < 0.0001 vs. baseline), FBG decreased by 67 mg/dl (p = 0.01 vs. baseline) | No data | BMI decreased by 0.3 (kg/m2) (p < 0.01 vs. baseline) | The Diabetes Tele Management System was successful in achieving glycemic controls at par with internationally accepted treatment |
| Su et al., 2019, USA 114 | Cohort study | 3 months, (n = 1336) | No data | HbA1c value was 7.1 ± 1.5% (p < 0.001 vs. baseline) | No data | No data | Higher levels of patient activation and engagement with remote patient monitoring technology were associated with better glycemic control outcomes |
| Musacchio et al., 2011, Italy 115 | Cohort study | 12 months, telemedicine group (n = 1004) | No data | Patients, HbA1c ⩽ 7.0% increased from 32.7 to 45.8% (p < 0.0001), while those, HbA1c ⩾ 9% decreased from 10.5 to 4.3% (p < 0.0001) | No data | No data | The SINERGIA model is effective in improving metabolic control and major cardiovascular risk factors |
| Turner et al., 2009, USA 116 | Exploratory study | 3 months, telemedicine group (n = 23) | No data | The decrease in HbA1c was 0.52 ± 0.91% | No data | No data | The technology improved the support available for T2D patients commencing insulin treatment. |
| Bergenstal et al., 2021, USA 117 | Cohort study | 10.2 ± 4.0 months, telemedicine group (n = 372) | no data | Significant reductions in HbA1c from baseline (−0.6 ± 1.5%, p < 0.001) | no data | no data | Intermittent use of rtCGM was well-received by adults with T2D and was associated with improvement in HbA1c |
| Michaud et al., 2018, USA 118 | Retrospective, observational study | 3 months, telemedicine group (n = 955) | no data | HbA1c value was 7.09 ± 1.44% (p < 0.001 vs. baseline) | no data | BMI value was 35.23 ± 7.74 kg/m2 (p < 0.001 vs. baseline) | This study found significant differences in clinical outcomes, especially HbA1c, at pre and post the 3-month remote patient monitoring intervention |
| Cheng et al., 2021119 | Cross-sectional study | 1 month, control group (n = 207), telemedicine group (n = 168) | Average change in FPG value was −38.82% (170 ± 6.1 mg/dL to 104 ± 26.1 mg/dL), Average change in 2−h PPG value was −29.29% ( 239 ± 35.5 mg/dL to 169 ± 44.7 mg/dL), Glucose variability value was 65.4 ± 35.1 mg/dL | Average change in FPG value was −41.72% (169 ± 6.3 mg/dL to 98.5 ± 21.1 mg/dL, p=0.027 vs. control), Average change in 2−h PPG value was −54.32% (243 ± 34.6 mg/dL to 111 ± 22.8 mg/dL, p<0.001 vs. control), Glucose variability value was 12.8 ± 7.3 mg/dL (p<0.001 vs. control) | No data | No data | Telemedicine may be a complementary option to assist in the management of glucose variability in diabetes |
| Shane-McWhorter et al., 2014, USA 120 | A nonrandomized prospective observational preintervention–postintervention, Study | 6 months, (n = 95) | No data | Average change in HbA1c was −1.92% (9.73 to 7.81) (p < 0.0001 vs. baseline) | No data | No data | Telemonitoring improved clinical outcomes and may be a useful tool to help enhance disease management |
| Yu et al., 2014, Canada 121 | A single-arm pre–post cohort study | 9 months | No data | Average change in HbA1c was 0.37% in general ( no seperated) | No data | No data | A self-management website for patients with type 2 diabetes did not improve self-efficacy |
| Berman et al., 2018, USA 122 | Cohort study | 12 weeks, (n = 101) | No data | Average change in HbA1c was −0.8 ± 1.3% (p < 0.001 vs. baseline) | No data | No data | Clinically meaningful reductions in HbA1c were observed with use of the FareWell digital therapeutic |
| Shane-McWhorter et al., 2015, USA 123 | Cohort study | 9 months, control group (n = 75), telemedicine group (n = 75) | Average change in HbA1c was −0.66 ± 1.99% (p = 0.009 vs. baseline) | Average change in HbA1c was −2.07 ± 2.36% (p < 0.001 vs. baseline, p < 0.001 vs. control) | Average change in BMI was 0.07 ±1.13 kg/m2 (p = 0.577 vs. baseline) | Average change in BMI was 0.11 ±1.55 kg/m2 (p = 0.535 vs. baseline) | Compared with usual care, a pharmacist-driven telemonitoring program showed a significant improvement in patients’ A1C levels. |
| Dixon et al., 2020, United States 124 | Technology report | The mean follow−up time period was 4.2 months (125.6 ± 22.4 days), (n = 740) | No data | HbA1c decreased by 2.3 ± 1.9%, 0.7 ± 1.0%, and 0.2 ± 0.8% across the baseline categories of > 9.0%, 8.0% to 9.0%, and 7.0% to < 8.0%, respectively (all p < 0.001) | No data | No data | Virtual Diabetes Clinic may be associated with, related to improving HbA1c |
| Majithia et al., 2020, USA 125 | Prospective single-arm study | 4 months, telemedicine group (n = 55) | No data | HbA1c decreased 1.6 ± 1.0% (p < 0.001 vs. baseline) | No data | BMI decreased 1.34 ± 1.5 kg/m2 (p < 0.001 vs. baseline) (n = 54) | After 4 months, there was a decrease in the HbA1C of the participating patients from baseline |
| Kim et al., 2006, Korea 126 | Pre–post test | 12 weeks, telemedicine group (n = 33) | No data | HbA1c value was 7.0 ± 1.1%, average change value was −1.1 ± 2.1 % (p= 0.006) | No data | No data | SMS intervention improved HbA1c level |
| Mayes et al., 2010, USA 127 | Pre–post test | 3.5 years, telemedicine group (n = 16) | no control | The difference between the last and first value for HbA1c (mean 7.2% vs. 9.6%, respectively) was −2.4% (a decrease of 21%) | No data | No data | Video conferencing via the Internet can provide a useful tool to assure that patients who adopt and utilize ADA protocols for diabetes will improve their glucose control |
| McGloin et al., 2020, Ireland 128 | An observational, pre–post, multimethod, and triangulation design | 12 weeks, telemedicine group (n = 39) | No data | HbA1c value was 8.01%, HbA1c (mmol/mol) decreased significantly −17.13 mmol/mol; p < 0.001) | No data | BMI value was 30.15 ± 6.82 kg/m2 | The mean HbA1c (mmol/mol) decreased significantly with no significant impact on weight |
| Bollyky et al., 2018, USA 129 | Pre–posttest | 90 days, telemedicine group (n = 275) | no data | HbA1c value was 7.1 ± 1.4% | no data | no data | Livongo participation significantly improves BG control in people with T2D |
| McGloin et al., 2015, Ireland 130 | A longitudinal mixed method case study | 12 months, (n = 8) | No data | HbA1c level was 7.63 ± 1.5% | No data | BMI was 35.6 ± 6.6 kg/m2 | The change of HbA1c was not significant |
| Carter et al., 2011, USA 131 | Not reported | 9 months, control group (n = 21), telemedicine group (n = 26) | HbA1c value was 7.9 % (p < 0.05 vs. baselime) | HbA1c value was 6.82 % (p < 0.05 vs. baseline) | BMI value was 26.5 (p < 0.05 vs. baselime) | BMI value was 23.8 (p < 0.05 vs. baselime) | Treatment group participants were more likely to achieve positive outcomes in terms of lowered hemoglobin A1c and body mass index measurements than were control group members |
| King et al., 2009, USA 132 | Initial pilot program | 12 months, control group (n = 43), telemedicine group (n = 14) | HbA1c decreased by 0.06% (p = 0.395) | HbA1c decreased by 0.46% (p =0.095) | No data | No data | Reductions in HbA1c did not achieve statistical significance potentially |
| Carallo et al., 2015, Singapore 133 | Not reported | 1 year, control group (n = 208), telemedicine group (n = 104) | The change was not statistically significant | HbA1c value was 54 ± 8 mmol/mol (p = 0.01) | The change was not statistically significant | BMI value was 30.5 ± 4.6 kg/m2 (p = 0.03) | Health care program based on GPs empowerment and taking care plus remote consultation with Consultants is at least as effective as standard outpatient management |
| Chen et al., 2011, Taiwan 134 | Not reported | 1 year, control group (n = 47), telemedicine group (n = 44) | HbA1c changed by −0.6 ± 2.6% (p = 0.202 vs. baseline) | HbA1c changed by −1.4 ± 1.5% (p < 0.001 vs. baseline) | No data | No data | The intensive diabetes management program with the telehealth system is a useful education method to improve blood sugar control in poorly controlled T2D patients receiving insulin injections |
| Myers et al., 2021, USA 135 | Pilot study | 3 months, Telephone (n = 13), Telehealth (n = 9) | The telephone arm had a 0.50% greater reduction in HbA1c (2.07% vs 2.57%, p = 0.70) than the telehealth group | No data | No data | The change in HbA1c was not statistically different across arms | |
| Istepanian et al., 2014, Iraq 136 | Case study | 6 month, control group (n = 6), telemedicine group (n = 6) | HbA1c decreased from 8.95 ± 2.17% to 8.7 ± 1.7% (p = 0.448) | HbA1c decreased from 8.95 ± 0.73% to 8.05 ± 1.31% (p = 0.115) | No data | No data | The key outcome of this study is the effectiveness of the mobile management systems and intervention in lowering the HbA1c level. |
| Lim et al., 2009, Korea 137 | Not reported | 3 months, control group (n = 34), telemedicine group (n = 67) | HbA1c value was 8.6 ± 0.3 %, FBS value was 166.4 ± 7.4 mg/dl | HbA1c value was 7.3 ± 0.2% (p < 0.001 vs. baseline), FBS value was 136.0 ± 4.3 mg/dl (p < 0.001 vs. baseline) | BMI was 24.9 ± 0.5 kg/m2 | BMI was 23.7 ± 0.4 kg/m2 (p < 0.001 vs. baseline) | Subjects in the telephone follow-up group showed a decrease in BMI, FBS, and HbA1c |
| Yoon et al., 2008, Korea 138 | Not reported | 12 months, control group (n = 26), telemedicine group (n = 25) | HbA1c value was 8.40 ± 1.04% (increased 0.81%, p < 0.05 vs. baseline) | HbA1c value was 6.77 ± 0.77% (decrease 1.32%, p < 0.05 vs. baseline) | No data | No data | Participants in the intervention group had lower HbA1c over 12 months when compared with the control group |
| Nesari et al., 2010, Iran 139 | Not reported | 3 months, control group (n = 30), telemedicine group (n = 30) | HbA1c value was 8.60 ± 1.88% (p = 0.150 vs. baseline) | HbA1c value was 7.04 ± 1.18% (p < 0.001 vs. baseline, p < 0.001 vs. control) | No data | No data | A nurse-led telephone follow-up was effective in enhancing the level of adherence to a diabetes therapeutic regimen, such that the HbA1c level decreased |
| McIlhenny et al., 2011, USA 140 | Not reported | 6 months, control group (n = 50), telemedicine group (n = 48) | HbA1c value was 7.49 ± 1.79%, Glucose level was 131.8 ± 45.6 mg/dl | HbA1c value was 6.52 ± 0.99% (p = 0.197 vs control), Glucose level was 102.4 ± 31.9 mg/dl (p = 0.008 vs. control) | Average weight was 98.1 ± 23.2 kg | Average weight was 97.2 ± 20.0 kg (p = 0.378 vs. control) | There was a significant difference in glucose levels between groups at 6 months |
| Kim et al., 2006, Korea 141 | Not reported | 12 weeks, control group (n = 23), WB group (n = 28), PM group (n = 22) | Average change in HbA1c was 0.43 ± 0.81%, Average change in FBS was 4.26 ± 4.48 mg/dl | WB:, Average change in HbA1c was −0.59 ± 0.61% (p = 0.01 vs. control), Average change in FBS was −14.14 ± 14.21 mg/dl (p = 0.01 vs. control), PM:, Average change in HbA1c was −0.51± 1.30 (p = 0.01 vs. control), Average change in FBS was −15.91 ± 13.23 mg/dl (p = 0.01 vs. control) | No data | No data | The findings of this study clearly indicate that both the WB and PM interventions were effective in enhancing the levels of physical activity and better in controlling FBS and HbA1c in Korean adults with type 2 diabetes |