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

Background: During the COVID-19 pandemic, telehealth was employed to enhance clinical outcomes for patients with type 2 diabetes mellitus. However, the effectiveness of telehealth remains inconclusive. Objective: This study aimed to examine the impact of telehealth on the glycemic control of individuals with type 2 diabetes mellitus during the pandemic. Design: A systematic review and meta-analysis of randomized controlled trials. Setting: N/A Participants: A total of 669 studies was sourced from electronic databases, including EMBASE, PubMed, and Scopus. Among these, twelve randomized controlled trials, comprising 1498 participants, were included. Methods: 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-effects model was utilized to combine the outcomes. Grading of Recommendations, Assessment, Development, and Evaluations was used to evaluate the certainty of the evidence. Results: 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 = .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). Conclusions: 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. Registration: The study was registered with PROSPERO, CRD42022381879.