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Research Summary
Analyzed using Evidence Intelligence™

Telemedicine lifestyle intervention modestly improves glycemic control in diabetes

Powered by the Dediabetes Evidence Intelligence™ framework

Last updated July 6, 2026

Key finding

Mean between-group difference in the complete-case analysis was -0.13% (95% CI, -0.25 to -0.01), P = 0.04.

A home-based lifestyle intervention with telemedicine support showed modest effects on HbA1c levels in patients with coronary heart disease and type 2 diabetes.

Quick read

Study at a glance

The essential study design details in one scan.

EvidenceScore™

Moderate

Study type

RCTs

Follow-up

Long-Term (1–5 y)

Risk of bias

Some Concerns

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Plain-language summary

What this paper says

A plain-language read of the study’s main message and where it applies.

Study focus

A home-based lifestyle intervention with telemedicine support showed modest effects on HbA1c levels in patients with coronary heart disease and type 2 diabetes.

Clinical relevance

Improving glycemic control is crucial for patients with CHD and T2DM, as it may reduce the risk of complications. While the intervention showed a modest effect on HbA1c, the lack of significant impact on cardiovascular events highlights the need for comprehensive strategies in managing these patients.

Keep in mind

The study had a modest sample size, which may limit the generalizability of the findings. The intervention's long-term effects beyond 12 months were not assessed. The statistical significance of some outcomes was not achieved, indicating uncertainty in effectiveness.

Published in

Journal Reference

Publication details and source links for this paper.

Stephan M, Sophia MTD, Felix G, et al. A home-based lifestyle intervention with telemedicine support showed modest effects in patients with CHD and T2DM. Nature Medicine. 2025;31(4):1203-1213. doi:10.1038/s41591-025-03498-w

View DOIView on PubMedView on PMC

Main Effects

The lifestyle intervention reduced HbA1c by -0.13% (95% CI, -0.25 to -0.01), P = 0.04.

At 12 months, 31 patients (6.2%) experienced a major adverse cardiovascular event; P = 0.15.

Hospitalizations for angina or revascularization were higher in the lifestyle intervention group (n = 15) compared to usual care (n = 8).

Evidence network

How this study fits

Understand where this research contributes within the broader evidence network.

Evidence Context

This study contributes evidence to Lifestyle intervention for prediabetes and Composite cardiovascular events (CV death, MI, stroke, HF hospitalization), Deaths, HbA1c, and 2 more.

This study contributes evidence to

Intervention

Lifestyle intervention for prediabetes

Outcome

Composite cardiovascular events (CV death, MI, stroke, HF hospitalization)

Evidence topic

Cardiovascular Risk

Primary intervention

Lifestyle intervention for prediabetes

Primary outcomes

  • Composite cardiovascular events (CV death, MI, stroke, HF hospitalization)
  • Deaths
  • HbA1c

Evidence topics

Cardiovascular RiskHbA1c Reduction

Primary intervention

Lifestyle intervention for prediabetes

Primary outcomes

Composite cardiovascular events (CV death, MI, stroke, HF hospitalization)DeathsHbA1c

Evidence relationships

Intervention and outcome relationships this study adds to the evidence network.

5
Evidence pairs
5
Relationships
2
Evidence topics
contributes_evidence

Editorial context

Why this study matters

See why this paper is useful beyond its individual results.

Evidence network role

This section describes how the study fits into the current evidence network. It does not determine whether an intervention works on its own.

Moderate contributionModerate confidenceNetwork score: 68

2

Related topics

5

Evidence pairs

659

Related studies

High relevance in at least one topic

Why it is useful

  • Contributes to 5 evidence relationships
  • Includes primary outcome data
  • Linked to 2 direct semantic evidence topics

Topic contributions

Evidence topic

Contributes evidence

Evidence topic

Contributes evidence

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Primary evidence

Evidence topic

Cardiovascular Risk

matched_outcome

Related evidence

Evidence topic

HbA1c Reduction

Save evidence

Core evidence

Study findings

The primary outcomes reported in this study.

Composite cardiovascular events (CV death, MI, stroke, HF hospitalization)

Lifestyle intervention for prediabetes → Composite cardiovascular events (CV death, MI, stroke, HF hospitalization)

Lifestyle intervention for prediabetes → Composite cardiovascular events (CV death, MI, stroke, HF hospitalization)

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
50
Neutral
ConsistencyScore™
unclear
Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence Tracker

Deaths

Lifestyle intervention for prediabetes → Deaths

Lifestyle intervention for prediabetes → Deaths

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
50
Neutral
ConsistencyScore™
unclear
Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence Tracker

HbA1c

Lifestyle intervention for prediabetes → HbA1c

Lifestyle intervention for prediabetes → HbA1c

Evidence Intelligence™
EvidenceScore™
87
Strong
ImpactScore™
85
Very Positive
ConsistencyScore™
82
consistent
Supporting studies: Based on 17 studies
Add to Evidence Tracker

Hospitalizations

Lifestyle intervention for prediabetes → Hospitalizations

Lifestyle intervention for prediabetes → Hospitalizations

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
50
Neutral
ConsistencyScore™
unclear
Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence Tracker

Hospitalizations for angina or revascularization

Lifestyle intervention for prediabetes → Hospitalizations for angina or revascularization

Lifestyle intervention for prediabetes → Hospitalizations for angina or revascularization

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
50
Neutral
ConsistencyScore™
unclear
Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence Tracker

Evidence Library

Build your evidence library

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evidence suggest

Evidence Suggest

  • HbA1c levels decreased by -0.13% with the intervention (P = 0.04).
  • No significant difference in composite cardiovascular events (P = 0.15).
  • More hospitalizations for angina in the intervention group (n = 15) compared to usual care (n = 8).
who this applies

Who this applies to

  • Adults diagnosed with coronary heart disease.
  • Patients with type 2 diabetes mellitus.
  • Individuals seeking lifestyle interventions to manage their health.
keep in mind

Keep in Mind

  • The modest improvement in HbA1c may not translate into significant clinical benefits.
  • Findings may not be applicable to populations outside the study's demographic.
  • Further research is needed to explore long-term outcomes and effectiveness.
between the lines

Between the Lines

  • The study had a modest sample size, which may limit the generalizability of the findings.
  • The intervention's long-term effects beyond 12 months were not assessed.
  • The statistical significance of some outcomes was not achieved, indicating uncertainty in effectiveness.

Evidence Library

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Connected Evidence

Explore related studies, evidence collections, and research questions.

Relationships organized using the Dediabetes Evidence Intelligence™ framework.

Powered by the Dediabetes Evidence Intelligence™ framework

This study contributes to evidence on Lifestyle intervention for prediabetes and HbA1c, Lifestyle intervention for prediabetes and Cardiovascular Outcomes.

Related evidence relationships

Explore in Evidence Explorer

This study contributes to the evidence on the following intervention-outcome relationships.

Explore more in Evidence Explorer

Jump to pre-filtered views in Evidence Explorer.

All studies on Lifestyle intervention for prediabetes and HbA1c

Intervention: Lifestyle intervention for prediabetesOutcome: HbA1c

17 results

All studies on Lifestyle intervention for prediabetes and Composite cardiovascular events (CV death, MI, stroke, HF hospitalization)

Intervention: Lifestyle intervention for prediabetesOutcome: Composite cardiovascular events (CV death, MI, stroke, HF hospitalization)

1 results

All studies on Lifestyle intervention for prediabetes

Intervention: Lifestyle intervention for prediabetes

17 results

All studies measuring HbA1c

Outcome: HbA1c

17 results

All studies measuring Composite cardiovascular events (CV death, MI, stroke, HF hospitalization)

Outcome: Composite cardiovascular events (CV death, MI, stroke, HF hospitalization)

1 results

Questions answered by this study

Generated from the study's connected evidence using Evidence Intelligence™.

Does Lifestyle intervention for prediabetes lower HbA1c?

Strong Evidence

Lifestyle intervention for prediabetes appears to lower HbA1c.

ConsistencyScore™: Results are consistent across studies.

Ranked evidence signals

  1. 1

    HbA1c

    EvidenceScore™ Strong | EvidenceScore™ 87.4 | strong positive | ConsistencyScore™ Consistent | 1 study

Why this answer: This answer is based on a single supporting study.

Limitations

  • Only one supporting study is available.
1 supporting study
View Full Evidence

Does Lifestyle intervention for prediabetes improve composite cardiovascular events (cv death, mi, stroke, hf hospitalization)?

Emerging Evidence

Current evidence does not show a clear benefit of Lifestyle intervention for prediabetes for composite cardiovascular events (cv death, mi, stroke, hf hospitalization).

ConsistencyScore™: Consistency cannot yet be determined from the available evidence.

Ranked evidence signals

  1. 1

    Composite cardiovascular events (CV death, MI, stroke, HF hospitalization)

    EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study

Why this answer: This answer is based on a single supporting study.

Limitations

  • Only one supporting study is available.
1 supporting study
View Full Evidence

Does Lifestyle intervention for prediabetes improve deaths?

Emerging Evidence

Current evidence does not show a clear benefit of Lifestyle intervention for prediabetes for deaths.

ConsistencyScore™: Consistency cannot yet be determined from the available evidence.

Ranked evidence signals

  1. 1

    Deaths

    EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study

Why this answer: This answer is based on a single supporting study.

Limitations

  • Only one supporting study is available.
1 supporting study
View Full Evidence

Does Lifestyle intervention for prediabetes improve hospitalizations?

Emerging Evidence

Current evidence does not show a clear benefit of Lifestyle intervention for prediabetes for hospitalizations.

ConsistencyScore™: Consistency cannot yet be determined from the available evidence.

Ranked evidence signals

  1. 1

    Hospitalizations

    EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study

Why this answer: This answer is based on a single supporting study.

Limitations

  • Only one supporting study is available.
1 supporting study
View Full Evidence
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Next steps

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Evidence topics

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Cardiovascular Risk Evidence HubHbA1c Reduction Evidence Hub

Explore in Evidence Explorer

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All studies on Lifestyle intervention for prediabetes and HbA1cAll studies on Lifestyle intervention for prediabetes and Composite cardiovascular events (CV death, MI, stroke, HF hospitalization)All studies on Lifestyle intervention for prediabetes and DeathsAll studies on Lifestyle intervention for prediabetes and Hospitalizations

Related research

Read related research summaries.

Intensive lifestyle intervention may improve type 2 diabetes remission ratesHealthy lifestyle reduces diabetes risk in high genetic risk womenCommunity lifestyle programme improves multiple diabetes risk factors in adults with prediabetesEngagement in a prediabetes education programme is linked to lower type 2 diabetes riskHome-based intervention may help prevent diabetes in women with GDM

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