---
title: "Telemedicine for Gestational Diabetes: Meta-analysis of Randomized Trials"
id: "pubmed-42913437"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42913437"
content_type: "clinical_feed_article"
specialty: "Critical Care"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42913437/"
doi: "10.2196/103569"
published_at: "2026-10-23T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Telemedicine for Gestational Diabetes: Meta-analysis of Randomized Trials
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42913437
- **Specialty:** [Critical Care](https://medichelpline.com/clinical-feed/critical-care.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42913437/)
- **DOI:** [10.2196/103569](https://doi.org/10.2196%2F103569)
- **Published At:** 2026-10-23T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- The authors performed a systematic review and meta-analysis of randomized controlled trials assessing **telemedicine** interventions in women with **gestational diabetes mellitus** (GDM). - Literature searches covered PubMed, Embase, Cochrane Library, Web of Science, and Scopus through August 16, 2026; two reviewers screened studies and extracted data independently. - Twenty-three RCTs with a combined 3055 women with GDM were included; risk of bias was evaluated using RoB 2 and evidence certainty by GRADE. - Pooled analyses showed statistically significant reductions in fasting glucose (MD −0.26), 2-hour postprandial glucose (MD −0.50), and gestational weight gain (MD −0.78), though 95% prediction intervals crossed the null for those outcomes. - Telemedicine was associated with lower risks of cesarean section, emergency cesarean section, macrosomia, neonatal hypoglycemia, and neonatal respiratory distress based on pooled estimates reported by the study team. - No significant pooled differences were detected for hemoglobin A1c, preterm birth, or neonatal ICU admission according to the abstract. - The outcomes for fasting glucose, 2-hour postprandial glucose, and gestational weight gain showed very high, unexplained heterogeneity (I2 > 90%), limiting confidence in pooled estimates. - GRADE ratings ranged from very low to low across outcomes; the authors concluded evidence remains tentative and recommended that telemedicine should not replace standard antenatal care. - The investigators called for larger, well-designed RCTs with standardized definitions of telemedicine, full reporting of intervention components, and long-term follow-up to confirm sustained maternal and neonatal benefit.
## Clinical Analysis & Structured Key Points
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Affiliations Expand ### Affiliations * 1 School of Nursing, Chengdu University of Traditional Chinese Medicine, No. 37, Shierqiao Road, Chengdu, Sichuan, China. * 2 Department of Orthopedics, Hospital of Chengdu University of Traditional Chinese Medicine, No. 39, Shierqiao Road, Chengdu, Sichaun, China. * 3 School of Medicine, University of Electronic Science and Technology of China, No. 4, Section 2, Jianshe North Road, Chengdu, Sichuan, China. * 4 Dean's Office, Guang'an Hospital of Traditional Chinese Medicine, No. 1 Cuiping Road, Guang'an, Sichuan, 638099, China, 86 15520799476. # Contributed equally. * PMID: **42913437** * DOI: [ 10.2196/103569 ](https://doi.org/10.2196/103569) Item in Clipboard Review # The Impact of Telemedicine Interventions on Maternal and Fetal Outcomes in Women With Gestational Diabetes: Systematic Review and Meta-Analysis of Randomized Controlled Trials Hongyue He et al. J Med Internet Res. 2026. Show details Display options Display options Format Abstract PubMed PMID J Med Internet Res Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22J+Med+Internet+Res%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22J+Med+Internet+Res%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42913437/) . 2026 Oct 23:28:e103569. doi: 10.2196/103569. ### Authors [Hongyue He](https://pubmed.ncbi.nlm.nih.gov/?term=He+H&cauthor_id=42913437)[#](https://pubmed.ncbi.nlm.nih.gov/42913437/#short-view-equal-contrib-explanation "Contributed equally")[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42913437/#short-view-affiliation-1 "School of Nursing, Chengdu University of Traditional Chinese Medicine, No. 37, Shierqiao Road, Chengdu, Sichuan, China."), [Juan Deng](https://pubmed.ncbi.nlm.nih.gov/?term=Deng+J&cauthor_id=42913437)[#](https://pubmed.ncbi.nlm.nih.gov/42913437/#short-view-equal-contrib-explanation "Contributed equally")[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42913437/#short-view-affiliation-1 "School of Nursing, Chengdu University of Traditional Chinese Medicine, No. 37, Shierqiao Road, Chengdu, Sichuan, China.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42913437/#short-view-affiliation-2 "Department of Orthopedics, Hospital of Chengdu University of Traditional Chinese Medicine, No. 39, Shierqiao Road, Chengdu, Sichaun, China."), [Jingxian Liu](https://pubmed.ncbi.nlm.nih.gov/?term=Liu+J&cauthor_id=42913437)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42913437/#short-view-affiliation-1 "School of Nursing, Chengdu University of Traditional Chinese Medicine, No. 37, Shierqiao Road, Chengdu, Sichuan, China."), [Xiaohong Xu](https://pubmed.ncbi.nlm.nih.gov/?term=Xu+X&cauthor_id=42913437)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42913437/#short-view-affiliation-1 "School of Nursing, Chengdu University of Traditional Chinese Medicine, No. 37, Shierqiao Road, Chengdu, Sichuan, China."), [Jiao Chen](https://pubmed.ncbi.nlm.nih.gov/?term=Chen+J&cauthor_id=42913437)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42913437/#short-view-affiliation-1 "School of Nursing, Chengdu University of Traditional Chinese Medicine, No. 37, Shierqiao Road, Chengdu, Sichuan, China."), [Lixin Liu](https://pubmed.ncbi.nlm.nih.gov/?term=Liu+L&cauthor_id=42913437)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42913437/#short-view-affiliation-1 "School of Nursing, Chengdu University of Traditional Chinese Medicine, No. 37, Shierqiao Road, Chengdu, Sichuan, China."), [Haoyue Zhang](https://pubmed.ncbi.nlm.nih.gov/?term=Zhang+H&cauthor_id=42913437)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42913437/#short-view-affiliation-3 "School of Medicine, University of Electronic Science and Technology of China, No. 4, Section 2, Jianshe North Road, Chengdu, Sichuan, China."), [Fang Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+F&cauthor_id=42913437)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42913437/#short-view-affiliation-4 "Dean's Office, Guang'an Hospital of Traditional Chinese Medicine, No. 1 Cuiping Road, Guang'an, Sichuan, 638099, China, 86 15520799476.") ### Affiliations * 1 School of Nursing, Chengdu University of Traditional Chinese Medicine, No. 37, Shierqiao Road, Chengdu, Sichuan, China. * 2 Department of Orthopedics, Hospital of Chengdu University of Traditional Chinese Medicine, No. 39, Shierqiao Road, Chengdu, Sichaun, China. * 3 School of Medicine, University of Electronic Science and Technology of China, No. 4, Section 2, Jianshe North Road, Chengdu, Sichuan, China. * 4 Dean's Office, Guang'an Hospital of Traditional Chinese Medicine, No. 1 Cuiping Road, Guang'an, Sichuan, 638099, China, 86 15520799476. # Contributed equally. * PMID: **42913437** * DOI: [ 10.2196/103569 ](https://doi.org/10.2196/103569) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID Linked Discoveries ## Abstract **Background:** Gestational diabetes mellitus (GDM) has a rising global prevalence and brings short-term and long-term adverse risks for mothers and fetuses. Conventional in-person GDM care is limited by time and geographic barriers, often resulting in suboptimal compliance and delayed individualized interventions. Telemedicine is increasingly applied in GDM management; however, randomized controlled trial (RCT) evidence remains inconsistent. **Objective:** The study aims to pool data from RCTs to quantify the effects of telemedicine on glycemic control and pregnancy-related outcomes in women with GDM and to inform optimized clinical management. **Methods:** We searched PubMed, Embase, Cochrane Library, Web of Science, and Scopus up to August 16, 2026. Two reviewers independently performed study screening and data extraction. Risk of bias was assessed using RoB 2. Meta-analyses were conducted in Stata 18.0. For heterogeneous outcomes, 95% prediction intervals (PIs) were calculated to estimate effect ranges for future studies. Heterogeneity was explored via leave-one-out sensitivity, meta-regression, and subgroup analyses. The GRADE (Grading of Recommendations Assessment, Development, and Evaluation) framework rated evidence certainty. Publication bias was evaluated for outcomes reported in ≥10 studies. **Results:** Twenty-three RCTs (3055 women with GDM) were included. Pooled estimates suggested that telemedicine may reduce fasting glucose (mean difference [MD] -0.26, 95% CI -0.42 to -0.09, 95% PI -0.93 to 0.42; _P_ =.002), 2-hour postprandial glucose (MD -0.50, 95% CI -0.87 to -0.14, 95% PI -1.84 to 0.84; _P_ =.007), and gestational weight gain (MD -0.78, 95% CI -1.40 to -0.17, 95% PI -2.83 to 1.26; _P_ =.01). Telemedicine was also associated with lower risks of cesarean section, emergency cesarean section, macrosomia, neonatal hypoglycemia, and neonatal respiratory distress. No significant differences were found for hemoglobin A1c, preterm birth, or neonatal intensive care unit admission. Notably, fasting glucose, 2-hour postprandial glucose, and gestational weight gain exhibited very high unexplained heterogeneity (_I_ ²>90%), with their 95% PIs crossing the null value despite statistically significant pooled effects. The GRADE certainty of evidence was very low to low across all assessed outcomes. **Conclusions:** Telemedicine may improve selected glycemic and perinatal outcomes for women with GDM and may serve as a promising supplementary option for prenatal care, particularly in resource-limited settings where routine in-person follow-up is difficult to implement. Nevertheless, the apparent benefits for glycemic control and gestational weight gain remain tentative due to extreme, unexplained between-study heterogeneity and 95% PIs crossing the null. Based on current evidence, telemedicine should not completely replace standard antenatal care. Future well-designed, large-sample RCTs are warranted; such trials should adopt standardized definitions for telemedicine interventions, fully report intervention components, and conduct long-term follow-up to verify sustained maternal and neonatal clinical benefits. **Keywords:** gestational diabetes mellitus; maternal and fetal outcomes; meta-analysis; systematic review; telemedicine. © Hongyue He, Juan Deng, Jingxian Liu, Xiaohong Xu, Jiao Chen, Lixin Liu, Haoyue Zhang, Fang Wang. Originally published in the Journal of Medical Internet Research (https://www.jmir.org). 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