Telehealth in the comprehensive management of diabetes mellitus: a narrative review

Abstract

Diabetes mellitus represents a critical public health challenge due to its increasing prevalence and potentially disabling consequences. In the digital era, telehealth has emerged as a strategy to optimize comprehensive monitoring and longitudinal disease management. The objective of this review was to describe the characteristics of telehealth in metabolic control and to identify opportunities for improving its implementation. A descriptive literature review was conducted using PubMed, Google Scholar, and the Cochrane Library, covering the period from January 2020 to February 2025. MeSH and DeCS descriptors, together with Boolean operators, were used in the search strategy. After analyzing 30 studies, the evidence was categorized into clinical effectiveness, operational advantages, limitations, public health impact, and satisfaction. The reviewed evidence showed favorable effects of telehealth on glycated hemoglobin (HbA1c) control, although substantial heterogeneity was observed across populations and interventions. Telehealth also facilitated patient follow-up and metabolic control. However, its implementation faces limitations related to the digital divide, particularly in rural areas, access to technological tools, and the learning curve among older adults. Therefore, telehealth represents an alternative or complementary approach to the care of patients with diabetes mellitus, although its implementation should take into account population characteristics and access to technology.