Telehealth and Digital Interventions for Type 2 Diabetes and Hypertension in Latin America and the Caribbean: A Systematic Review and Meta-Analysis.

BACKGROUND

Telehealth, remote monitoring, and other digital interventions may support chronic disease management, but evidence from Latin America and the Caribbean (LAC) remains fragmented. We evaluated clinical effectiveness and characterized human support, clinical integration, and implementation.

METHODS

PubMed, Scopus, SciELO, and LILACS were searched through July 2026 for studies of digital interventions in adults with type 2 diabetes or hypertension in LAC. Random-effects meta-analyses were restricted to randomized trials and used restricted maximum likelihood estimation, Hartung-Knapp adjustment, and 95% prediction intervals (PIs). Evidence certainty was assessed using Grading of Recommendations Assessment, Development, and Evaluation.

RESULTS

Thirty-six studies (41 reports) from 12 countries were included: 15 randomized and 21 nonrandomized. Six trials (n = 689) showed lower HbA1c (mean difference [MD] -1.23 percentage points; 95% confidence interval [CI] -2.19 to -0.26; I2 = 83.8%; PI: -3.64 to 1.18). Seven trials (n = 2,280) showed lower systolic blood pressure (SBP; MD: -4.97 mmHg; 95% CI: -7.15 to -2.79; I2 = 26.1%; PI: -8.85 to -1.09), and five (n = 1,825) showed lower diastolic blood pressure (DBP; MD: -3.46 mmHg; 95% CI: -5.69 to -1.22; I2 = 76.1%; PI: -9.24 to 2.33). Certainty was moderate for SBP and low for HbA1c and DBP. Professional support and clinical integration were common, whereas sustainability, scalability, interoperability, costs, and equity were inconsistently evaluated.

CONCLUSIONS

Digitally enabled chronic care may improve glycemic and blood-pressure control in LAC, with the most consistent evidence for SBP. Heterogeneous intervention models and limited implementation evidence warrant comparative effectiveness-implementation studies.