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Telemedicine in Type 2 Diabetes Care: Two Stories of Success

Telemedicine in Type 2 Diabetes Care: Two Stories of Success

  • Telemedicine in Type 2 Diabetes Care: Two Stories of Success

  • Telemedicine Lifestyle Intervention in Advanced T2D.1 Benefits of lifestyle interventions in advanced DM unclear; structured intervention, includes telemonitoring, telemedical coaching, mental motivational training, protein-rich meal replacement, SMBG

  • Single-center interventional study in Germany; adults with advanced T2DM, randomized to usual care or TeLiPro (includes one-on-one phone calls with diabetes coach)

  • Controls vs Intervention (TeLiPro). Control subjects had routine care (quarterly visits with their attending physician) TeLiPro group received dietary intervention, a weekly 20-min care call from trained diabetes coaches.

  • TeLiPro Linked to Significantly Improved A1c vs control; treatment difference at 12 weeks maintained at week 52; improvements in weight, BMI, systolic BP, 10-y CVD risk, reduced medication use, quality of life, eating behavior.

  • TeLiPro: Promising Tool for Lifestyle Intervention in Advanced T2D. “The current study shows that TeLiPro can significantly improve A1c levels in patients with advanced stage type 2 diabetes and poor glycemic control…”

  • Telescreening for Diabetic Retinopathy in Primary Care. North Carolina Diabetic Retinopathy Telemedicine Network provides evaluations to diabetes patients in underserved areas; telemedicine may increase early detection, access to care.

  • Pre-Post Implementation Study of Telescreening for DR. Used nonmydriatic fundus photography with remote expert interpretation; majority of patients were women, minorities.

  • Increased Rates of DR Evaluation with Telescreening. Rate increased from 25.6% to 40.4% pre/post-implementation; 9.3% had DR with need for an ophthalmology referral; 60.0% of referred patients completed ophthalmology visits.

  • Telescreening for DR: Improved Access to Care. “This pre-post study found that the burden of advanced diabetic retinopathy requiring referral to an ophthalmologist was disproportionately high among minorities…”

  • Telemedicine in T2DM Care: Take-home Points.Telemedicine lifestyle intervention, including coaching, for advanced T2D significantly improved A1c, health-related variables; benefits maintained at 52 weeks. Pre-post implementation study found telescreening for diabetic retinopathy in primary care significantly improved rates of telescreening in rural, underserved areas.

Telemedicine relies on timely transmission and remote interpretation of patient data for follow-up and to tailor intervention. A primary goal of these long-distance connections between health care professional and patient is to improve treatment results. 

This short slide show highlights two interventions, one targeting patients with advanced diabetes with lifestyle support and the other improving access to eye care for diabetes patients in an underserved community, that both significantly improved outcomes.




1. Kempf K, Altpeter B, Berger J, et al. Efficacy of the telemedical lifestyle intervention program TeLiPro in advanced stages of T2D: a randomized controlled trial. Diabetes Care. 2017l;40):863-871.

2. Jani PD, Forbes L, Choudhury A, et al. Evaluation of diabetic retinal screening and factors for ophthalmology referral in a telemedicine network. JAMA Ophthalmol. 2017;135:706-714. doi:  10.1001/jamaophthalmol.2017.1150.

3. Saaddine JB, Honeycutt AA, Narayan KMV, et al. Projection of diabetic retinopathy and other major eye diseases among people with diabetes mellitus: United States, 2005-2050. Arch Ophthalmol. 2008;126:1740-1747.

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