Abstract
Aim: Diabetes Self-Management Education and Support (DSMES) is recommended as standard care. Telehealth may extend DSMES beyond clinic settings, but its effects on self-efficacy and quality of life are unclear. We evaluated the effectiveness of telehealth for DSMES on (1) self-efficacy and (2) quality of life (QoL) in adults with type 2 diabetes mellitus.
Methods: This study is a systematic review and meta-analysis of randomized controlled trials following the Cochrane Handbook guidelines and PRISMA2020. Following PRISMA, six databases (PubMed, Scopus, Embase, Cochrane, CINAHL, Web of Science) were searched from 2000 to 10 October 2025, plus reference lists. Eligible studies were randomized controlled trials of telehealth DSMES versus usual care or traditional DSMES in adults with type 2 diabetes reporting self-efficacy and/or quality of life. Two reviewers independently screened studies, extracted data, and assessed risk of bias. Random-effects meta-analyses produced standardized mean differences (SMDs) with 95% confidence intervals (CIs). Publication bias tests, leave-one-out and risk-of-bias sensitivity analyses, and prespecified subgroup analyses and meta regression were conducted.
Results: Eighteen randomized controlled trial (n = 4,073) were included. Across thirteen trials reporting self-efficacy, telehealth for DSMES statistically significantly improved self-efficacy versus usual care (SMD = 0.94; 95% CI 0.28–1.61; p = 0.01). The finding was robust to trim-and-fill, leave-one-out analyses, and exclusion of high-risk trials. In subgroup analyses, synchronous delivery showed a statistically significant benefit (p = 0.04). For QoL, ten effects from six studies showed no overall benefit (SMD = 0.09; 95% CI −0.10 to 0.27; p = 0.31). In the 12-Item Short Form Survey (SF-12) subdomains, neither the physical nor the mental component showed significant improvement.
Conclusion: Telehealth for DSMES improves self-efficacy in adults with type 2 diabetes, with larger gains when synchronous sessions are included. QoL did not improve significantly, and the limited, heterogeneous evidence warrants caution.
Notes
Reference list included in attached slide deck.
Sigma Membership
Non-member
Lead Author Affiliation
Taipei Medical University, Taipei, Taiwan, ROC
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Meta-Analysis/Synthesis
Research Approach
Quantitative Research
Keywords:
Diabetes Self-Management Education and Support, DSMES, Health Self-Care, Self-Management (Psychology), Type 2 Diabetes, Telehealth, Telemedicine, Self-Efficacy, Quality of Life
Recommended Citation
Subpaiboonkit, Ramida; Burhan, Asmat; and Tsai, Hsiu-Ting, "Effectiveness of Telehealth for DSMES Among Type 2 Diabetes: A Systematic Review and Meta-Analysis" (2026). International Nursing Research Congress (INRC). 18.
https://www.sigmarepository.org/inrc/2026/presentations_2026/18
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-07-22
Effectiveness of Telehealth for DSMES Among Type 2 Diabetes: A Systematic Review and Meta-Analysis
Toronto, Ontario, Canada
Aim: Diabetes Self-Management Education and Support (DSMES) is recommended as standard care. Telehealth may extend DSMES beyond clinic settings, but its effects on self-efficacy and quality of life are unclear. We evaluated the effectiveness of telehealth for DSMES on (1) self-efficacy and (2) quality of life (QoL) in adults with type 2 diabetes mellitus.
Methods: This study is a systematic review and meta-analysis of randomized controlled trials following the Cochrane Handbook guidelines and PRISMA2020. Following PRISMA, six databases (PubMed, Scopus, Embase, Cochrane, CINAHL, Web of Science) were searched from 2000 to 10 October 2025, plus reference lists. Eligible studies were randomized controlled trials of telehealth DSMES versus usual care or traditional DSMES in adults with type 2 diabetes reporting self-efficacy and/or quality of life. Two reviewers independently screened studies, extracted data, and assessed risk of bias. Random-effects meta-analyses produced standardized mean differences (SMDs) with 95% confidence intervals (CIs). Publication bias tests, leave-one-out and risk-of-bias sensitivity analyses, and prespecified subgroup analyses and meta regression were conducted.
Results: Eighteen randomized controlled trial (n = 4,073) were included. Across thirteen trials reporting self-efficacy, telehealth for DSMES statistically significantly improved self-efficacy versus usual care (SMD = 0.94; 95% CI 0.28–1.61; p = 0.01). The finding was robust to trim-and-fill, leave-one-out analyses, and exclusion of high-risk trials. In subgroup analyses, synchronous delivery showed a statistically significant benefit (p = 0.04). For QoL, ten effects from six studies showed no overall benefit (SMD = 0.09; 95% CI −0.10 to 0.27; p = 0.31). In the 12-Item Short Form Survey (SF-12) subdomains, neither the physical nor the mental component showed significant improvement.
Conclusion: Telehealth for DSMES improves self-efficacy in adults with type 2 diabetes, with larger gains when synchronous sessions are included. QoL did not improve significantly, and the limited, heterogeneous evidence warrants caution.
Description
This systematic review and meta-analysis estimated the effectiveness of telehealth for DSMES on self-efficacy and quality of life in adults with type 2 diabetes mellitus. Telehealth for DSMES improves self-efficacy in adults with type 2 diabetes. QoL did not improve significantly. Overall, these findings support integrating Tele-DSMES, preferably with synchronous contact and adequate follow-up, into routine care to strengthen self-management.