Self-management is an effective component of effective diabetes care and is reported to improve short-term clinical outcomes. A recent study, published in the journal Journal of Telemedicine and Telecare, reports telemonitoring to be associated with significantly reduced HbA1c and 1.8 times improved achievement rates of HbA1c <7% than usual care in patients with type 2 diabetes mellitus (T2DM).
Authors identified 38 randomised controlled trials involving 6855 patients with T2DM. The primary outcomes were improving HbA1c and achievement rate of target HbA1c level <7% and hypoglycaemic incidence.
Telemonitoring was associated with significantly reduced HbA1c levels vs usual care (weighted mean difference, [WMD], –0.42%; 95% CI, –0.56 to –0.27). HbA1c levels of telemonitoring vs usual care group were significantly lower among studies that provided counselling (WMD, –0.47%; 95% CI, –0.60 to –0.34), education (WMD, –0.46%; 95% CI, –0.59 to –0.34) and automated feedback messages for diabetes management (WMD, –0.47%; 95% CI, –0.60 to –0.33). Telemonitoring improved HbA1c levels in studies that transmitted biological data through web or Internet (WMD, –0.68%, 95% CI, –0.73 to –0.63) and where voice feedback was provided (WMD, –0.73%; 95% CI, –0.80 to –0.65). The rate of achieving HbA1c levels <7% was 1.8 times higher in the telemonitoring vs usual care group (risk ratio, 1.83; 95% CI, 1.35-2.47). Hypoglycaemic incidence was not significantly different between the 2 groups.
Authors believe that their findings would facilitate development of a telemonitoring intervention protocol and an enhanced mobile application for diabetes care. They call for further studies that would assess clinical benefit according to specific delivery modes and patient-reported outcomes.
