The impact of telehealth‐delivered Medical Nutrition Therapy on diabetes outcomes in rural general practice: A secondary analysis of the Healthy Rural Hearts randomised controlled trial

Aims To evaluate glycaemic control in adults enrolled in a rural cardiovascular disease prevention trial receiving Medical Nutrition Therapy (MNT) delivered via telehealth versus usual care. Materials and Methods This secondary analysis used a subsample of participants ( N = 81, n = 56 intervention, n = 25 control) with diagnosed or possible diabetes from the ‘Healthy Rural Hearts’ cluster randomised controlled trial (RCT), conducted in a large rural area in Australia. The general practitioner (GP) (primary care physician) reported ‘diagnosed’ diabetes, while ‘possible diabetes’ was a baseline fasting blood glucose level (FBG) ≥5.5 mmol/L or glycated haemoglobin (HbA1c) ≥6.0%. The intervention group received five telehealth‐based MNT sessions over 6 months. Both control and intervention groups received usual care from their GP ( n = 7 and n = 9 primary care practices, respectively) and up to four personalised nutrition reports. Within and between group changes in FBG and HbA1c were calculated from baseline to 12 months using Bayesian hierarchical regression models and reporting posterior mean differences and 95% credible intervals (CrI). Results Results suggested between group differences of −0.43 mmol/L in FBG (95% CrI −1.05, 0.19) and −0.26% in HbA1c (95% CrI −0.51, −0.00) at 12 months, when accounting for medication use. Evidence ratios of 10.64 and 39.45 indicate that the posterior probability of a positive intervention effect was approximately 10.6 and 39.5 times higher than that of a negative effect for FBG and HbA1c, respectively. Conclusions Current results indicate that MNT delivered via telehealth supports improvement in glucose control in individuals with diagnosed diabetes and possible diabetes. Larger studies are needed to confirm these findings in similar populations.