Remote Monitoring Systems for Self-Managing Type 2 Diabetes: A Systematic Review

The aim of our systematic review is: to evaluate evidence for feasibility and impact of telemedicine and web-based telemonitoring for managing Type 2 Diabetes Mellitus. We used MEDLINE, EMBASE, CINAHL, AMED, Cochrane and PubMed to conduct our search using the terms: telemonitoring for type-II diabetes mellitus self-management using web-based Internet solutions. The technology used, trial design, quality of life and the Glycated haemoglobin (HbA1c) outcome measures used were extracted for systemic reviews and meta-analyses, randomised controlled trials and cohort studies. Our search identified 426 publications; 19 only publications met our search criteria. Ten quasi-experiments out of which seven are pre-post test studies, two are cohort studies and one is interrupted time-series study and nine randomised controlled trials (RCT). Electronic transfer of glucose results from home to hospital appears to be more feasible for healthcare delivery. Six of these studies were conducted in USA, six in South Korea, three in the United Kingdom, two in Taiwan and one in each of Spain, Poland and India. The duration of the studies varied from four weeks to eighteen months and the participants were all adults. Fifteen studies showed positive improvement in HbA1c levels. One study showed high acceptance of the technology among participants. In the end, it remains challenging to identify evidence in the rapidly changing area of remote monitoring in diabetes care. Both the technology and its typology are complex. The optimal design of a telemedicine system is still uncertain and the impact of the real-time blood glucose transmissions is still controversial.