Effectiveness of Nurse-Led Telehealth Compared With Usual Care on Glycemic Control and Body Mass Index in Adults With Type 2 Diabetes: A Systematic Review and Meta-Analysis.

AIMS AND

OBJECTIVES

To evaluate the effectiveness of nurse-led telehealth compared with usual care on glycemic control and body mass index in adults with type 2 diabetes mellitus (T2DM).

BACKGROUND

Nurse-led telehealth may support diabetes self-management between clinic visits, but its effectiveness for adults with T2DM remains uncertain.

METHODS

Five databases were searched from September 2015 to January 2026. Randomized controlled trials comparing nurse-led telehealth with usual/conventional care in adults with T2DM were included. Two reviewers independently screened studies, extracted data, and assessed risk of bias. Random-effects meta-analyses pooled mean differences (MDs) with 95% confidence intervals (CIs). The primary outcome was change in HbA1c. Secondary outcomes included BMI and FPG. PROSPERO registration: CRD420251149835.

RESULTS

Eleven RCTs were included in the systematic review; 10 contributed to meta-analysis, while 1 was synthesized narratively due to non-extractable outcome data. Nurse-led telehealth significantly reduced HbA1c compared with usual care (MD = -0.62%, 95% CI -0.90 to -0.34; p < 0.0001). BMI showed a borderline but non-significant reduction favouring nurse-led telehealth (MD = -0.61 kg/m2, 95% CI -1.23 to 0.01; p = 0.05). FPG did not differ significantly between groups (MD = -0.62 mmol/L, 95% CI -2.10 to 0.86; p = 0.41).

CONCLUSIONS

Nurse-led telehealth improves HbA1c compared with usual care and appears to be a promising adjunct to routine diabetes care delivered by nurses. Further trials should clarify intervention intensity and fidelity and evaluate longer-term outcomes relevant to nursing practice.

RELEVANCE TO CLINICAL PRACTICE: This review supports integrating structured nurse-delivered remote follow-up into clinical pathways to strengthen ongoing diabetes self-management between clinic visits. The complexity of symptom burden, treatment workload and patient engagement should be considered, underscoring the importance of tailoring and ongoing support in nurse-led telehealth programmes.

TRIAL REGISTRATION: PROSPERO (CRD420251149835).