Effectiveness of telehealth on the glycemic control of patients with type 2 diabetes mellitus during the COVID-19 pandemic: A systematic review and meta-analysis of randomised controlled trials
Chantira Chiaranai, Saranya Chularee, Surasak Saokaew, Patraporn Tungpunkom, Adinat Umnuaypornlert, Natthaya Chaomuang, Nudchaporn Doommai, Porntip Nimkuntod
Abstract
During the COVID-19 pandemic, telehealth has been employed to enhance clinical outcomes for patients with type 2 diabetes mellitus. However, the effectiveness of telehealth remains inconclusive. This study aimed to examine the impact of telehealth on glycemic control of individuals with type 2 diabetes mellitus during the pandemic. A systematic review and meta-analysis of randomized controlled trials. N/A A total of 669 studies were sourced from electronic databases, including EMBASE, PubMed, and Scopus. Among these, twelve randomized controlled trials, comprising 1,498 participants, were included. A comprehensive search was performed in electronic databases. The quality of the included studies was assessed using the Cochrane Risk of Bias tool, and statistical heterogeneity was assessed using I² and Cochran's Q tests. A random-effect model was utilized to combine the outcomes. Grading of Recommendations, Assessment, Development, and Evaluations was used to evaluate the certainty of the evidence. The meta-analysis showed that participants receiving a telehealth intervention achieved a greater reduction in the glycated haemoglobin (HbA1C) compared to those receiving usual care, with a weighted-mean difference of -0.59 (95% CI -0.84 to -0.35, p < .001, I² =74.1%, high certainty of evidence). Additionally, participants receiving telehealth interventions experienced better secondary outcomes, including a reduction in fasting blood sugar (16.06%, 95%CI -29.64 to -2.48, p = 0.02, high certainty of evidence), a decrease in body mass index (1.5%, 95%CI -1.98 to -1.02, p < .001, high certainty of evidence), and a decrease in low-density lipoprotein (7.8%, 95%CI -14.69 to -0.88, p = .027, low certainty of evidence). In our review, we showed telehealth's positive impact on glycaemic control in type 2 diabetes mellitus patients. Healthcare professionals can use telehealth in diabetes care. Caution is needed due to heterogeneity of the results. Further research should explore the long-term impacts of telehealth interventions. The study was registered with PROSPERO, CRD42022381879.