P-383: Effectiveness and implementation of telemedicine-supported care for children and adolescents with type 1 diabetes in low- and middle-income countries: a systematic review
J Andhoga, C PatelAbstract
Introduction
Children and adolescents with type 1 diabetes in low- and middle-income countries (LMICs) face limited access to specialist care, poor glycemic outcomes, and high rates of acute complications. Telemedicine has emerged as a potential strategy to address these gaps, but its effectiveness in LMIC pediatric populations remains incompletely defined.
Objectives
To systematically evaluate the effectiveness and implementation of telemedicine-supported diabetes care on clinical and health system outcomes in children and adolescents with type 1 diabetes in LMICs.
Methods
A systematic review was conducted in accordance with PRISMA guidelines. PubMed, Embase, Scopus, and African Index Medicus were searched for studies published between 2010 and 2025. Eligible studies included individuals ≤19 years with type 1 diabetes receiving telemedicine-supported care in LMICs. Outcomes included HbA1c, acute complications, healthcare utilisation, and patient-reported measures. Study quality was assessed using standardised tools, and findings were synthesised narratively.
Results
Eleven studies (n≈1,020 participants) from Africa, Asia, and Latin America met the inclusion criteria. Interventions included mobile health platforms, teleconsultations, and hybrid care models. Telemedicine-supported care was associated with reductions in HbA1c ranging from 0.5% to 1.1%, with greater improvements in programs incorporating structured education and frequent remote follow-up. Several studies reported reductions in diabetes-related hospitalisations and improved clinic attendance. Patient and caregiver satisfaction was consistently high. However, heterogeneity in study design and intervention delivery limited comparability. Key implementation barriers included unreliable internet access, limited device availability, and low digital literacy.
Conclusions
Telemedicine-supported care is associated with meaningful improvements in glycemic control and healthcare engagement among children and adolescents with type 1 diabetes in LMICs.