The effectiveness of telemedicine in the prevention of type 2 diabetes: a systematic review and meta-analysis of interventions

Objective To evaluate the effectiveness of telemedicine-delivered diet and/or exercise interventions to prevent type 2 diabetes (T2D) in people at risk. Methods Embase (via Ovid), Medline (via Ovid), Web of Science, CINAHL, Scopus and SciELO were searched from January 2010-December 2020 for intervention studies using a diet and/or exercise intervention delivered through telemedicine for T2D prevention in people at risk. Parallel randomised controlled trials were meta-analyzed and other intervention designs narratively synthesised. Results We identified 11,645 studies via database searches, of which 226 were full text screened, and 52 interventions included; 32 were included in the meta-analysis and 20 in the narrative synthesis. Telemedicine interventions reduced body weight (mean difference (MD): -1.66 kg, 95% confidence interval (CI) -2.48,-0.90, I 2 =81%, n studies =17), body mass index (MD -0.71 kg/m 2 , 95% CI -1.06,-0.37, I 2 =70%, n studies =11), waist circumference (MD -2.82 cm, 95% CI -5.16,-2.35, I 2 =84%, n studies =7) and HbA1c (MD -0.07%, 95% CI -0.14,0.00, I 2 =71%, n studies =11). No significant effects were found for other clinical outcomes. The narrative synthesis supported the results. Conclusions Our study highlights the potential for telemedicine-delivered interventions in preventing T2D in people at risk.