Effectiveness of Nurse-led Telehealth Compared with Usual Care on Glycemic Control in Adults with Type 2 Diabetes: A Systematic Review and Meta-analysis

Objective This systematic review and meta-analysis aimed to evaluate the effectiveness of nurse-led telehealth interventions, compared with usual care, on glycemic control in adults with type 2 diabetes mellitus (T2DM). Methods A comprehensive search was conducted in PubMed, Web of Science, CINAHL, Embase, the Cochrane Library and Medline from database inception to August 2025. Randomized controlled trials (RCTs) comparing nurse-led telehealth with usual or conventional care in adults with T2DM were included. Two reviewers independently screened studies, extracted data, and assessed risk of bias using the Cochrane Risk of Bias tool (RoB 2.0). RevMan 5.4 software was used for statistical synthesis. The primary outcome was change in glycated hemoglobin (HbA1c, %). The secondary outcome was body mass index (BMI, kg/m²). Results A total of 11 RCTs were included in the systematic review. The pooled results from the meta-analysis demonstrated that nurse-led telehealth significantly lowered HbA1c levels in T2DM patients compared to conventional care (MD= -0.54%, 95% CI: -0.79 to -0.30; P < 0.001). In addition, the intervention group achieved a significant reduction in BMI (MD = -0.74 kg/m ² , 95% CI: -1.40 to -0.08; P < 0.05). Conclusion Nurse-led remote care improves both glycemic control and weight-related outcomes in adults with T2DM. These findings support the integration of nurse-led telehealth into routine diabetes management as a clinically beneficial and scalable strategy.