Effect of virtual care in type 2 diabetes management – a systematic umbrella review of systematic reviews and meta-analysis
Abstract Background Diabetes is an increasingly prevalent and costly chronic disease worldwide, and a large cause of unnecessary disease burden. To address the growing burden of diabetes, care models should support management of diabetes in primary care to reduce reliance on overstretched hospital-b...
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2025-03-01
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| Online Access: | https://doi.org/10.1186/s12913-025-12496-0 |
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| author | Sumathy Ravi Gideon Meyerowitz-Katz Cassia Yung Julie Ayre Kirsten McCaffery Glen Maberly Carissa Bonner |
| author_facet | Sumathy Ravi Gideon Meyerowitz-Katz Cassia Yung Julie Ayre Kirsten McCaffery Glen Maberly Carissa Bonner |
| author_sort | Sumathy Ravi |
| collection | DOAJ |
| description | Abstract Background Diabetes is an increasingly prevalent and costly chronic disease worldwide, and a large cause of unnecessary disease burden. To address the growing burden of diabetes, care models should support management of diabetes in primary care to reduce reliance on overstretched hospital-based specialists services. Virtual care presents an opportunity to provide diabetes care remotely, potentially enhancing the accessibility and efficiency of healthcare services. This review aimed to identify existing evidence on the effectiveness of virtual care on diabetes management, and the extent to which video components are included in the evidence base. Methods The protocol was registered in PROSPERO (CRD42022366125). Systematic search of the databases PubMed, Embase, Medline, Scopus, CINAHL and Cochrane CENTRAL, were conducted for studies on telemedicine, telehealth, or virtual interventions for type 2 diabetes management published between January 2011 to March 2022. The primary outcome was HbA1c, and secondary outcomes were blood glucose control, Body Mass Index (BMI), taking the prescribed medications, and self-management behaviour. The results were reported following the Preferred Reporting Items for Systematic Reviews (PRISMA) checklist. Quality of each review was appraised using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Systematic Reviews and Research Syntheses. Results From 10,708 articles, 63 underwent full-text review. Thirty systematic reviews were included. Overall quality of the included reviews was high. Among the 30 systematic reviews, there was significant overlap of the primary studies, with 48% of them appearing in multiple reviews. Of the 30 reviews, 28 reported that virtual care improved HbA1c compared to usual care. Meta-analysis of 16 reviews revealed a mean difference of -0.37% (-0.41% to -0.32%), I2 of 77.1%. Significant non-clinical impacts were noted for BMI and secondary outcomes. Most reviews (25/30) included some studies with video components, however these studies did not disaggregate the impact of video from other aspects of complex interventions such as web-based and telephone support. Conclusions This umbrella review strengthens the evidence that virtual care significantly improves clinical outcomes in people with type 2 diabetes, primarily affecting HbA1c. Fewer studies addressed other health outcomes such as BMI and taking medications. Effectiveness of virtual care varies by demographic and clinical characteristics, emphasising the need to tailor virtual care interventions to maximise impact. Future research could directly compare and identify the most effective virtual care strategies for different populations, including those with lower digital literacy. |
| format | Article |
| id | doaj-art-19107a4fd5a04b33aa189ba5dbc46ca4 |
| institution | OA Journals |
| issn | 1472-6963 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj-art-19107a4fd5a04b33aa189ba5dbc46ca42025-08-20T01:57:25ZengBMCBMC Health Services Research1472-69632025-03-0125111510.1186/s12913-025-12496-0Effect of virtual care in type 2 diabetes management – a systematic umbrella review of systematic reviews and meta-analysisSumathy Ravi0Gideon Meyerowitz-Katz1Cassia Yung2Julie Ayre3Kirsten McCaffery4Glen Maberly5Carissa Bonner6Western Sydney Diabetes, Integrated and Community Health, Western Sydney Local Health DistrictWestern Sydney Diabetes, Integrated and Community Health, Western Sydney Local Health DistrictSydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and Health, The University of SydneySydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and Health, The University of SydneySydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and Health, The University of SydneyWestern Sydney Diabetes, Integrated and Community Health, Western Sydney Local Health DistrictSydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and Health, The University of SydneyAbstract Background Diabetes is an increasingly prevalent and costly chronic disease worldwide, and a large cause of unnecessary disease burden. To address the growing burden of diabetes, care models should support management of diabetes in primary care to reduce reliance on overstretched hospital-based specialists services. Virtual care presents an opportunity to provide diabetes care remotely, potentially enhancing the accessibility and efficiency of healthcare services. This review aimed to identify existing evidence on the effectiveness of virtual care on diabetes management, and the extent to which video components are included in the evidence base. Methods The protocol was registered in PROSPERO (CRD42022366125). Systematic search of the databases PubMed, Embase, Medline, Scopus, CINAHL and Cochrane CENTRAL, were conducted for studies on telemedicine, telehealth, or virtual interventions for type 2 diabetes management published between January 2011 to March 2022. The primary outcome was HbA1c, and secondary outcomes were blood glucose control, Body Mass Index (BMI), taking the prescribed medications, and self-management behaviour. The results were reported following the Preferred Reporting Items for Systematic Reviews (PRISMA) checklist. Quality of each review was appraised using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Systematic Reviews and Research Syntheses. Results From 10,708 articles, 63 underwent full-text review. Thirty systematic reviews were included. Overall quality of the included reviews was high. Among the 30 systematic reviews, there was significant overlap of the primary studies, with 48% of them appearing in multiple reviews. Of the 30 reviews, 28 reported that virtual care improved HbA1c compared to usual care. Meta-analysis of 16 reviews revealed a mean difference of -0.37% (-0.41% to -0.32%), I2 of 77.1%. Significant non-clinical impacts were noted for BMI and secondary outcomes. Most reviews (25/30) included some studies with video components, however these studies did not disaggregate the impact of video from other aspects of complex interventions such as web-based and telephone support. Conclusions This umbrella review strengthens the evidence that virtual care significantly improves clinical outcomes in people with type 2 diabetes, primarily affecting HbA1c. Fewer studies addressed other health outcomes such as BMI and taking medications. Effectiveness of virtual care varies by demographic and clinical characteristics, emphasising the need to tailor virtual care interventions to maximise impact. Future research could directly compare and identify the most effective virtual care strategies for different populations, including those with lower digital literacy.https://doi.org/10.1186/s12913-025-12496-0Type 2 diabetesVirtual careTelemedicineTelehealthVideoconferencingUmbrella review |
| spellingShingle | Sumathy Ravi Gideon Meyerowitz-Katz Cassia Yung Julie Ayre Kirsten McCaffery Glen Maberly Carissa Bonner Effect of virtual care in type 2 diabetes management – a systematic umbrella review of systematic reviews and meta-analysis BMC Health Services Research Type 2 diabetes Virtual care Telemedicine Telehealth Videoconferencing Umbrella review |
| title | Effect of virtual care in type 2 diabetes management – a systematic umbrella review of systematic reviews and meta-analysis |
| title_full | Effect of virtual care in type 2 diabetes management – a systematic umbrella review of systematic reviews and meta-analysis |
| title_fullStr | Effect of virtual care in type 2 diabetes management – a systematic umbrella review of systematic reviews and meta-analysis |
| title_full_unstemmed | Effect of virtual care in type 2 diabetes management – a systematic umbrella review of systematic reviews and meta-analysis |
| title_short | Effect of virtual care in type 2 diabetes management – a systematic umbrella review of systematic reviews and meta-analysis |
| title_sort | effect of virtual care in type 2 diabetes management a systematic umbrella review of systematic reviews and meta analysis |
| topic | Type 2 diabetes Virtual care Telemedicine Telehealth Videoconferencing Umbrella review |
| url | https://doi.org/10.1186/s12913-025-12496-0 |
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