Outcomes and experience of telemedicine in the management of diabetes mellitus during COVID-19 pandemic

Shahjada Selim, Hafiza Lona


Background: Telemedicine has been promoted as an economical and effective way to enhance patient care, but the experience and its outcome in the diabetes management are not well understood. Thus, this study aims to assess the experiences and outcomes of diabetes management by tele-consultation.

Methods: A comparative study included 958 patients with T2DM attending the clinics for diabetes management. Of them 467 (48.75%) patients consulted the endocrinologists through telemedicine and 491 (51.25%) patients attended the clinics physically during the study period.

Results: The mean age was 58.5±4.3 years in telemedicine group and 55.8±5.1 years in the physically attending group. Male patients comprised about half [46.03% in telemedicine group; 51.32% in physically attending group)] of the study population and around half [55.46% in telemedicine, 44.54% in physically attending group] of them came from urban areas. The majority of patients were on MNT along with 2 or more OADs [42.18% versus 40.53%; p 0.90]. Among telemedicine users, 59.74% visited the clinic as regular follow up visits and the highest number of patients [49.67% (232)] used video calling, apps, WhatsApp. About 62.21% (291) of the telemedicine users did not face any difficulties in communication. Two-fifths of the participants (40.02%) required assistance for communication; 74.09% of the patients could understand the advices and instructions of the physicians and 76.45% found it cost effective and more than four-fifths of them admitted that telemedicine could save time. The majority of patients with T2DM (91.43%) were satisfied with telemedicine service.

Conclusions: For most patients with T2DM, telemedicine can be as good, or even better than, in-person care, especially for those who face geographical and time barriers to access during COVID-19 pandemic and may be afterword. population.


Corona virus, COVID-19, Diabetes mellitus, Telemedicine, Virtual consultation

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Teleconsultation enables medical authorities to remotely examine Covid-19 suspects; curbing disease transmission. ETHealthWorld. 2020. infosolutions-launches-telemedicine-teleconsultation-to-fight-covid-19-pandemic/75161427. Last accessed on 19th August, 2020.

Telemedicine Practice Guidelines by BOARD OF GOVERNORS In supersession of the Medical Council of India & NITI Aayog. 2020.

Telemedicine-Opportunities and developments in member states [Internet] 2nd ed. Geneva, Switzerland: WHO press; 2010. Last accessed on 19th August, 2020.

WHO Corona virus (COVID-19) dashboard. Data last updated. 2021. Last accessed on 19th August, 2020.

Corona Update Bangladesh. Available at:

Webster P. World report on Virtual health care in the era of covid 19. The lancet. 2020; 395(11).

Quinn LM, Davies MJ, Hadjiconstantinou M.Virtual Consultations and the Role of Technology During the COVID-19 Pandemic for People With Type 2 Diabetes: The UK Perspective J Med Internet Res. 2020;22(8):e2160.

Cahn A, Akirov A, Raz I. Digital health technology and diabetes management. J Diabetes. 2018;10(1):10-17.

NHS. Chapter 5: Digitally-Enabled Care Will Go Mainstream Across The NHS. Online version of the NHS Long Term Plan. 2020. URL: Last accessed on 19th August, 2020.

Alderwick H, Dixon J. The NHS long term plan. BMJ 2019 Jan 07;364:l84 How-To Guide: Non Face-To-Face Clinics. UCLPartners. 2020. Last accessed on 19th August, 2020.

Bakhai M, Croney L, Waller O, Henshall N, Felstead C. Using Online Consultations In Primary Care: Implementation Toolkit. NHS England. 2020. Last accessed on 19th August, 2020.

What is telehealth? NEJM Catalyst. Last accessed on 19th August, 2020.

Ghosh A, Gupta R, Misra A. Telemedicine for Diabetes Care in India during COVID19 Pandemic and National Lockdown Period: Guidelines for Physicians, Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 2020.

Mathur P, Srivastava S, Lalchandani A, Mehta JL. Evolving Role of Telemedicine in Health Care Delivery in India. Prim Health Care. 2017;7:260.

Selim S, Pathan F, Saifuddin M, Latif Z A, Karin N. The challenge of proper glycaemic control among Patients with type 2 diabetes in Bangladesh. SJDEM. 2016;6(2)1-5.

Chowdhury A, Sen N, Banik S. Prescribing pattern of antidiabetic drugs in type 2 diabetic patients of Noakhali city in Bangladesh. Marmara Pharm J. 2017;21(4):1010-1014.

Mohiuddin AK. Diabetes Fact: Bangladesh Perspective. International Journal of Diabetes Research. 2019;2(1):14-20.

Pathan MF, Fariduddin M, Nazimuddin K, Mollah AS, Islam-Siddiqui M N, Hassan KA et al. The Incidence of Hypoglycemia among Insulin-Treated Patients with Type 1 or Type 2 Diabetes: Bangladeshi Cohort of International Operations-Hypoglycemia Assessment Tool Study. Indian journal of endocrinology and metabolism. 2018;22(3):379-386.

Chaturvedi D, Nagda S, Yadav KS. Telemedicine consultation experiences of general population during national lockdown period for other than COVID-19 illness. IOSR-JNHS. 2020;9(5):53-59.

Telemedicine practice guidelines. Last accessed on 11th February, 2021.

Sood SP, Bhatia JS. Development of telemedicine technology in India: ‘Sanjeevani’- An integrated telemedicine application. J Postgrad Med. 2005;51:308-311.

Imlach, F., McKinlay, E., Middleton, L. et al. Telehealth consultations in general practice during a pandemic lockdown: survey and interviews on patient experiences and preferences. BMC Fam Pract. 2020;21:269.

Lee JY, Chan CKY, Chua SS. Using telemedicine to support care for people with type 2 diabetes mellitus: a qualitative analysis of patients’ perspectives. BMJ Open. 2019;9:e026575.

Lee JY, Lee SWH, Nasir NH. Diabetes telemonitoring reduces the risk of hypoglycaemia during Ramadan: a pilot randomized controlled study. Diabetic Medicine. 2015;32:1658-61.

Lee JY, Wong CP, Tan CSS. Telemonitoring in fasting individuals with type 2 diabetes mellitus during Ramadan: a prospective, randomised controlled study. Sci Rep. 2017;7:10119.

SWH L, Lee JY, San STC. Strategies to make Ramadan fasting safer in type 2 diabetics: a systematic review and network meta-analysis of randomized controlled trials and observational studies. Medicine. 2016;95.

Paré G, Jaana M, Sicotte C. Systematic review of home Telemonitoring for chronic diseases: the evidence base. Journal of the American Medical Informatics Association. 2007;14:269-77.

Hernandez C, Casas A, Escarrabill J. Home hospitalisation of exacerbated chronic obstructive pulmonary disease patients. European Respiratory Journal. 2003;21:58-67.