Table 3.
Effectiveness of telemedicine on glycated hemoglobin in patients with diabetes, according to intervention duration.
Application category and type of diabetes | Intervention duration | Trials, n | Patients, n | Outcome | MDa (95% CI) of percent change in HbA1cb | P value | I2 (%) | Grading of Recommendations, Assessment, Development, and Evaluation | |
Digital health education [56] | |||||||||
|
T1Dc/T2Dd | 3 months | 3 | 203 |
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−0.71 (−1.0 to −0.43) | .90 | 0 |
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|
T1D/T2D | 6 months | 2 | 562 |
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−0.52 (−0.75 to −0.29) | .65 | 0 |
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|
T1D/T2D | 12 months | 6 | 1153 |
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−0.55 (−0.7 to −0.39) | <.001 | 78 |
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Telemedicine [70,85] | |||||||||
|
T1D | <6 months | 7 | NSg |
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0.07 (−0.16 to 0.31) | NS | NS |
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|
T1D | ≥6 months | 21 | NS |
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−0.24 (−0.41 to −0.07) | NS | NS |
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|
T2D | ≤3 months | 17 | 1377 |
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−0.67 (−0.93 to −0.41) | NS | NS |
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|
T2D | 4-6 months | 36 | 4538 |
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−0.41 (−0.84 to 0.02) | NS | NS |
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|
T2D | 7-11 months | 4 | 659 |
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−0.66 (−1.18 to −0.15) | NS | NS |
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|
T2D | ≥12 months | 36 | 10,237 |
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−0.26 (−0.40 to −0.12) | NS | NS |
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Digital self-management [59,60,72,83] | |||||||||
|
T2D | ≤3 months | 10 | NS |
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−0.51 (−0.71 to −0.31) | <.001 | 41.8 |
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|
T2D | >3 and ≤6 months | 10 | NS |
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−0.48 (−0.68 to −0.28) | <.001 | 34.5 |
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|
T2D | 3-4 months | 11 | 1613 |
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−0.30 (−0.50 to −0.11) | <.001 | 89.1 |
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|
T2D | >6 months | 15 | NS |
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−0.35 (−0.53 to −0.18) | <.001 | 70.5 |
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|
T2D | 6-8 months | 14 | 2389 |
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−0.59 (−0.78 to −0.39) | <.001 | 84.8 |
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|
T2D | 9-12 months | 7 | 1272 |
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−0.21 (−0.35 to −0.075) | .131 | 39.1 |
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|
T1D/T2D | ≤ 6 months | 30 | NS |
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−0.56 (NS) | <.001 | 30 |
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|
T1D/T2D | 6 months | 6 | 741 |
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−0.57 (−0.85 to −0.30) | .099 | NS |
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|
T1D/T2D | >6 months | 25 | NS |
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−0.40 (NS) | <.001 | 25 |
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|
T1D/T2D | 12 months | 7 | 3466 |
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−0.30 (−0.48 to −0.11) | .099 | NS |
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Digital self-management (SMS) [75] | |||||||||
|
T2D | <6 months | 6 | NS |
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−0.60 (−0.80 to −0.40) | <.001 | NS |
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|
T2D | ≥6 months | 4 | NS |
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−0.40 (−0.56 to −0.24) | <.001 | NS |
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Digital self-management (social network service) [78] | |||||||||
|
T1D/T2D | ≤3 months | 13 | 799 |
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−0.54 (−0.80 to −0.28) | <.001 | 23 |
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|
T1D/T2D | 3-12 months | 11 | 1465 |
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−0.41 (−0.63 to −0.19) | <.001 | 25 |
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|
T1D/T2D | >12 months | 10 | 2713 |
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−0.36 (−0.59 to −0.14) | <.002 | 90 |
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aMD: mean difference.
bHbA1c: glycated haemoglobin
cT1D: type 1 diabetes.
dT2D: type 2 diabetes.
eThe direction of the arrows indicates potential clinically relevant reduction rates (see Table 2).
fGreen arrows show statistical significance.
gNS: not specified—cases in which no data were provided. Missing data on statistical significance were handled as nonsignificant.