Getie Addisu, Amlak Baye Tsegaye, Ayenew Temesgen, Gedfew Mihretie
Department of Nursing, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia.
BMC Health Serv Res. 2025 Feb 20;25(1):285. doi: 10.1186/s12913-025-12401-9.
The increasing prevalence of diabetes mellites (DM), especially type 2 diabetes mellitus, presents significant challenges for healthcare systems. Effective blood glucose management is essential for preventing serious complications, and telehealth offers a promising approach to improve patient engagement and adherence. The effectiveness of telehealth on blood glucose management should be investigated. The evaluated metric for diabetes management plans in this study was the change in blood glucose levels, specifically HbA1c, as an indicator of glycemic control. The impact of telehealth interventions on these outcomes was analyzed across various patient groups. This review conducts a comprehensive analysis of the current literature to offer insights that can guide clinical practices and inform policymakers about the advantages of telehealth in managing diabetes.
In this study, several evidence-based databases and relevant clinical trial registries were searched to evaluate the effects of telehealth on blood glucose management among patients with diabetes. The included studies were randomized controlled trials that compared telehealth with traditional in-person management. Microsoft Excel was used to extract and sort the data before it was exported to STATA/MP 17.0 for analysis. A weighted inverse variance random-effects model with a 95% confidence interval was employed to pool the data. Egger's test and Cochrane I statistics were used to assess publication bias and heterogeneity, respectively.
This review identified six randomized controlled trials (RCTs) involving a total of 3,995 patients, with 2,022 in the telehealth intervention group and 1,973 in the control group, conducted across the USA, Asia, and Europe. The analysis showed a significant improvement in blood glucose control for patients using telehealth, evidenced by a Standard Mean Difference (SMD) of 0.20 (95% CI: 0.10-0.29; p < 0.001), with USA studies reflecting the highest SMD of 0.24 and diabetic veterans showing an even greater SMD of 0.41.
This study demonstrates that telehealth interventions significantly enhance blood glucose management among patients with diabetes. The findings highlight the need for healthcare systems to prioritize telehealth integration into diabetes management protocols while developing tailored interventions to meet the diverse needs of various patient populations.
糖尿病，尤其是2型糖尿病的患病率不断上升，给医疗系统带来了重大挑战。有效的血糖管理对于预防严重并发症至关重要，而远程医疗为提高患者参与度和依从性提供了一种很有前景的方法。应研究远程医疗在血糖管理方面的有效性。本研究中糖尿病管理计划的评估指标是血糖水平的变化，特别是糖化血红蛋白（HbA1c），作为血糖控制的指标。在不同患者群体中分析了远程医疗干预对这些结果的影响。本综述对当前文献进行了全面分析，以提供可指导临床实践的见解，并让政策制定者了解远程医疗在糖尿病管理中的优势。
在本研究中，检索了几个循证数据库和相关临床试验注册库，以评估远程医疗对糖尿病患者血糖管理的影响。纳入的研究是将远程医疗与传统面对面管理进行比较的随机对照试验。在将数据导出到STATA/MP 17.0进行分析之前，使用Microsoft Excel提取和整理数据。采用具有95%置信区间的加权逆方差随机效应模型汇总数据。分别使用Egger检验和Cochrane I统计量评估发表偏倚和异质性。
本综述确定了六项随机对照试验（RCT），共涉及3995名患者，其中远程医疗干预组2022名，对照组1973名，试验在美国、亚洲和欧洲开展。分析表明，使用远程医疗的患者血糖控制有显著改善，标准化均数差（SMD）为0.20（95%CI：0.10 - 0.29；p < 0.001），美国的研究显示最高SMD为0.24，糖尿病退伍军人的SMD更高，为0.41。
本研究表明，远程医疗干预可显著改善糖尿病患者的血糖管理。研究结果强调，医疗系统在制定满足不同患者群体多样化需求的定制干预措施时，需要将远程医疗纳入糖尿病管理方案的优先事项。
