PP404 Effect Evaluation Of Two Family Doctor Contracting Service Models On Diabetic Patients: A Real-World Study In Chengdu, China

2020 ◽  
Vol 36 (S1) ◽  
pp. 34-34
Author(s):  
Li Zhou ◽  
Xingyue Zhu ◽  
Hongyuan Liu ◽  
Yanli Huang ◽  
Ming Hu
Keyword(s):  
Blood Pressure ◽  
Real World ◽  
Glycosylated Hemoglobin ◽  
Family Doctor ◽  
Diabetic Patients ◽  
Basic Service ◽  
Service Package ◽  
Service Group ◽  
Significant Difference ◽  
Service Models

IntroductionTo strengthen the care capacity of primary facilities, China has vigorously promoted the construction of a hierarchical medical system and a family doctor care system. In July 2017, a family doctor care plan was launched in an urban district of Chengdu, Sichuan Province, and two family doctor contracting service models were adopted, one provided a basic-service package and the other a paid-service package. In order to evaluate the effect of different models on diabetic patients, this study conducted a real world study based on the district healthcare database.MethodsDiabetic patients who contracted family doctor services January 2018 to January 2019 as reported in the database were enrolled in the paid- or basic-service group. Propensity score matching (PSM) was conducted to balance the distribution of covariances between the groups. The results of the first and last examination of glycosylated hemoglobin, low-density lipoprotein cholesterol (LDL-C), systolic and diastolic blood pressure in the groups were compared by independent sample t-test and chi-square test.ResultsIncluded were 4,871 patients in basic-service and 394 patients in paid-service. In both groups the total control rates of blood pressure, glycosylated hemoglobin and LDL-C at the last physical examination were 43.67, 79.28 and 51.11 percent, respectively, a significant increase from pre-test. The combined control rates of HbAlc, LDL-C and blood pressure in the basic- and paid-service group were 20.76% and 22.37%, respectively. After PSM, there was no significant difference between the groups.ConclusionsUp to now, there is no significant difference between basic-service and paid-service family doctor contracting service models in improving the comprehensive control rate of diabetic patients. The possible reasons may be that the quality and content of paid-service is not as good as expected, the period of implementation is not long enough and the sample size of paid-service patients is limited.

scholarly journals Serum High Lipoprotein(a) Levels in Patients with Type 2 Diabetes May Be an Independent Risk Factor for Hypertension

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Lingfen Zeng ◽  
Jieming Sun ◽  
Ming Cui
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Risk Factor ◽  
Independent Risk Factor ◽  
Glycosylated Hemoglobin ◽  
Serum Triglyceride ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Lipoprotein A

Objective — To investigate whether serum lipoprotein(a) [Lp(a)] is an independent risk factor for abnormal blood pressure in patients with type 2 diabetes mellitus. Method — Analyzed data collected from diabetes patients and epidemiological survey from January 1,2020 to May 01,2021, with hypertension as a dependent variable, metabolic index such as glycosylated hemoglobin, serum total cholesterol, serum triglyceride and Lp(a) were independent variables, established logistic regression equation, analyze the influence of their variables on dependent variables. Results — The OR value of Lp(a) is 1.020, 95% confidence intervals (1.006, 1.035), p 0.006; The OR value of age is 1.073, 95% confidence interval (1.028, 1.119); and OR of the remaining parameters were tested no statistically different, p>0.05. Conclusions — The abnormal elevated Lp(a) level in the serum of type 2 diabetic patients may be related to the occurrence of hypertension. For patients with high Lp(a), Monitoring blood pressure may help to better detect and diagnose hypertension. At the same time, it is suggested that reducing serum Lp(a) level may reduce the risk of hypertension.

scholarly journals Relationship between homocysteine and non-dipper pattern in patients with type 2 diabetes mellitus

2012 ◽  
Vol 56 (5) ◽  
pp. 285-290 ◽  
Author(s):  
Serdal Korkmaz ◽  
Abdulkerim Yilmaz ◽  
Gürsel Yildiz ◽  
Fatih Kiliçli ◽  
Serhat Içağasioğlu
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Control Group ◽  
Diabetic Patients ◽  
Nocturnal Blood Pressure ◽  
Type 2 Dm ◽  
Significant Difference

OBJECTIVE: The rate of reduction of nocturnal blood pressure (NBP) is lesser than normal in patients with type 2 diabetes mellitus (type 2 DM). Hyperhomocysteinemia (HHC) disrupts vascular structure and function, no matter the underlying causes. The risk of development of vascular disease is greater in diabetic patients with hyperhomocysteinemia than in patients with normal homocystein levels. The aim of the study was to investigate whether there are differences of homocystein levels in dipper and non-dippers patients with type 2 DM. SUBJECTS AND METHODS: We compared 50 patients (33 females, 17 males) with type 2 DM and 35 healthy individuals (18 females, 17 males ) in a control group. Ambulatory blood pressure monitoring (ABPM) was performed and homocysteine levels were measured in all patients. RESULTS: We found that the percentage of non-dipper pattern was 72% in patients with type 2 DM and 57% in control group. In diabetic and control individuals, homocystein levels were higher in non-dipper (respectively 13.4 ± 8.1 µmol/L and 11.8 ± 5 µmol/L) than in dipper subjects (respectively, 11.8 ± 5.8 µmol/L and 10.1 ± 4.2 µmol/L), but there was no significant difference between the two groups (respectively, p = 0.545, p = 0.294). CONCLUSION: In both groups, homocystein levels were higher in non-dipper than in dipper participants, but there was no significant difference between the groups. High homocystein levels and the non-dipper pattern increases cardiovascular risk. Therefore, the relationship between nocturnal blood pressure changes and homocystein levels should be investigated in a larger study.

scholarly journals Raised Arterial Pressure and Microalbuminuria in Type 2 Diabetic Subjects with Familial Hypertension

2016 ◽  
Vol 4 (1) ◽  
pp. 14-18
Author(s):  
Md Anisur Rahman ◽  
Md Mostarshid Billah ◽  
Palash Mitra ◽  
Md Emtiaz Hossan ◽  
Md Jakir Hossain ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arterial Pressure ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Familial Predisposition ◽  
Significant Difference ◽  
History Of ◽  
Family History Of Hypertension ◽  
Type 2 Diabetic

Background and Aims : Microalbuminuria is claimed to be an early marker of nephropathy in type 2 diabetes.The raised arterial pressure is an important factor in the progression of diabetic nephropathy. There is a significant correlation between blood pressure and the progression of albuminuria in both type 1 and type 2 diabetes. This study in Bangladeshi type 2 diabetic patients was to evaluate whether microalbuminuria and raised arterial pressure are influenced by familial predisposition to hypertension.Methods : Sixty three newly diagnosed Bangladeshi type 2 diabetic patients were investigated. The diabetic subjects were divided into two groups as diabetes with family history of hypertension (n=37) and diabetes without family history of hypertension (n=26). Diabetic subjects were further divided into normotensive (n= 46) and hypertensive (n= 17); diabetic normoalbuminuric (n 44) and diabetic microalbuminuric (n 19) subgroups. Serum glucose was measured by glucose-oxidase; blood urea, serum creatinine and urinary creatinine by enzymatic-colorimetric method and urinary albumin by immunoturbidimetry method.Results : systolic blood pressure (SBP), diastolic blood pressure (DBP) and microalbuminuria were significantly elevated in diabetic subjects with familial predisposition to hypertension when compared to diabetic subjects without familial predisposition to hypertension [SBP (127±16 vs 110±14) mmHg P= 0.001; DBP (81±9 vs 72±11) mmHg P= 0.001; Microalbuminuria 2.23(0.28-9.43) vs 1.52(.29-3.91) mg/mmol p<0.03]. When diabetic normotensive subjects were compared with diabetic hypertensive subjects for microalbuminuria, no significant difference was found among themselves [median (range) 1.67(0.17-8.62) vs 1.70(.28-9.43) mg/mmol p = NS]. Comparison of blood pressure was found no significant difference between diabetic normoalbuminuric and diabetic microalbuminuric subjects [systolic blood pressure (117±17 vs 125±17) mmHg p= NS ; diastolic blood pressure (76±11 vs 82±10) mmHg p= NS ].Conclusion : Microalbuminuria, a marker of early diabetic nephropathy and raised arterial pressure, a progression factor of nephropathy are more influenced by familial predisposition to hypertension in diabetic population irrespective of presence or absence of microalbuminuria and hypertension.Bangladesh Crit Care J March 2016; 4 (1): 14-18

scholarly journals Assessment of Corneal Endothelium among Diabetic Patients in a Multispecialty Hospital in Tamil Nadu

2020 ◽  
Author(s):  
Soundaram Meenakshisundaram ◽  
Melina I Sahay ◽  
Damal Kandadai Sriram ◽  
Melvin George
Keyword(s):  
Blood Pressure ◽  
Endothelial Cell ◽  
Blood Sugar ◽  
Cell Density ◽  
Corneal Thickness ◽  
Diabetic Group ◽  
Control Group ◽  
Diabetic Patients ◽  
Duration Of Diabetes ◽  
Significant Difference

Introduction: Corneal damage is the common issue affecting 70% of diabetic patients. Diabetic cornea has functional abnormalities such as decreased corneal Endothelial Cell Density (ECD), thicker corneas with increased endothelial permeability, lesser corneal sensitivity, and elevated corneal auto-fluorescence. Aim: To study the corneal endothelial characteristics among diabetic patients and to identify the factors associated with endothelial damage and compare the corneal changes based on the duration of diabetes mellitus and glycaemic control. Materials and Methods: The hospital based cross-sectional study was conducted in 155 patients (100 diabetic and 55 control) from 24th September 2016 to 29th March 2018. The corneal endothelial morphological features were evaluated using a non-contact EM-3000 specular microscope. The morphological characteristics of endothelial cell like the ECD, Coefficient of Variation (CV), Central Corneal Thickness (CCT), and percentage of hexagonal cells were compared between diabetic patients and the control population. Age, gender, blood pressure, duration of diabetes, fasting and Postprandial Blood Sugar (PPBS) HbA1c value, blood urea, and serum creatinine, Intra Ocular Pressure (IOP) were also recorded, and the endothelial cell characteristics were compared between the diabetic groups according to the duration (< or ≥ 3 years) and HbA1c% (< or ≥ 7%). An independent t-test was performed to compare the means of endothelial characteristics between study subjects and the control group and also between duration of diabetes and HbA1C levels. A p-value of less than 0.05 was considered statistically significant. The data were analysed using a SPSS statistical program. Results: Baseline characteristics like Fasting Blood Sugar (FBS), PPBS, HbA1c, Systolic and Diastolic Blood Pressure (SBP and DBP) were significantly higher in diabetic group than control. A significant difference in corneal thickness (p=0.01) and hexagonality (p<0.001) were also observed between both the groups. The diabetic group showed a reduction in cell density and a higher coefficient variation of cell size however the differences were not statistically significant, There was no significant difference in the ECD, CCT, CV, and hexagonality irrespective to HbA1c level and duration of diabetes. Conclusion: Patients with diabetes had a significant increase in corneal thickness, and a higher frequency of pleomorphism compared to control subjects. In terms of ECD and co-efficient variation, no difference was observed between groups.

scholarly journals Effect of Adding Losartan to Bevacizumab for Treating Diabetic Macular Edema

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Fariba Ghassemi ◽  
Abdulrahim Amini ◽  
Masoud Yasemi ◽  
Amin Nabavi ◽  
Mohammadkarim Johari
Keyword(s):  
Blood Pressure ◽  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Glycosylated Hemoglobin ◽  
Macular Thickness ◽  
Central Macular Thickness ◽  
Nonproliferative Diabetic Retinopathy ◽  
Significant Difference

Introduction. Diabetic retinopathy is the most common cause of visual loss and blindness in the age group of 20 to 64 years. This study aimed to evaluate the efficacy of oral Losartan adjuvant therapy in combination with intravitreal injection of Bevacizumab in the treatment of diabetic macular edema. Methods. In this randomized clinical trial, 61 eyes of 47 patients with normal blood pressure and diabetic macular edema and nonproliferative diabetic retinopathy were studied. Patients were randomly divided into Losartan (n = 33) and control (n = 28) groups. All patients received 3–6 intravitreal injections of Bevacizumab over 6 months. General examination including blood pressure and glycosylated hemoglobin measurements were performed in all patients. Complete ophthalmologic examination and macular OCT were performed at the first, third, and sixth months of treatment in all patients. Results. The mean age of the patients studied was 57.1 ± 7.4 years and 37.7% of the patients were male. There was no significant difference between the two groups in terms of initial visual acuity, central macular thickness, and frequency of injections. There was no significant difference in visual acuity and central macular thickness between the two groups at the first, third, and sixth months of treatment. Age, frequency of injection, and initial macular thickness less than 450 microns were effective in patients’ final visual acuity. Conclusion. Short-term adjuvant treatment with Losartan in patients with diabetic macular edema and nonproliferative diabetic retinopathy has no greater effect than the standard treatment.

Abstract 240: Prevalence of Intense Systolic Blood Pressure Control in Unselected Real World Non-Diabetic Hypertensive Patients

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Ravinder Valadri ◽  
Sandhya Reddy ◽  
Chien-Wen Yang ◽  
Hussain Azizi ◽  
Dan Loughran ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Clinical Practice ◽  
Systolic Blood Pressure ◽  
Real World ◽  
Current Trend ◽  
Diabetic Patients ◽  
Hypertensive Patients ◽  
Cardiovascular Morbidity And Mortality ◽  
End Stage ◽  
Clinic Visits

Background: Recent data from SPRINT trial demonstrated that, intense systolic blood pressure (ISBP) control to <120 mm Hg was associated with lower cardiovascular morbidity and mortality, compared to standard systolic BP (St-SBP) control to <140 mm Hg. We sought to determine current trend in the clinical practice in terms of intense SBP control. Methods: Electronic medical records from 3 different ambulatory clinics were reviewed to identify hypertensive patients with at least 3 consecutive clinic visits. Patients with diabetes, with <3 clinic visits, end-stage renal failure, and end stage liver failure were excluded. Cohort was categorized in to ISBP group and St-SBP group, when more than 50% of the clinic encounters had SBP ≤ 120 mm HG and > 120 mm Hg respectively. Results: 1644 non diabetic patients with HTN included in the analysis. 1389 (84.5%) patients had St-SBP control whereas only 255 (15.5%) patients had ISBP control. ISBP group had significantly lower mean (±SD) SBP compared to St-SBP group; 116(±6.4) mm Hg vs. 136(±11.6) mm Hg respectively; P<0.0001. Baseline characteristics shown in table 1. ISBP group and St-SBP group had similar comorbid profile, except slightly greater prevalence of COPD in ISBP 46 (18.0%) vs 165 (11.9%); P=0.007. Conclusion: There is significant variation in SBP control in non-diabetic hypertensive patients in clinical practice, despite comparable comorbid profile. Furthermore, ISBP control is not a common practice in real world. Quality improvement measures should focus on promoting ISBP control in non-diabetic hypertensive patients.

scholarly journals Renal Effects of Sulodexide in Type 2 Diabetic Patients without Nephrotic Range Proteinuria

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Kachonsak Yongwatana ◽  
Ouppatham Supasyndh ◽  
Bancha Satirapoj
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Renal Function ◽  
Diabetic Nephropathy ◽  
Control Group ◽  
Diabetic Patients ◽  
Long Term Effects ◽  
Renal Disease Progression ◽  
Significant Difference

Background. Glycosaminoglycan plays an important role in the maintenance of glomerular charge selectivity of diabetic nephropathy. Sulodexide, a mixture of naturally occurring glycosaminoglycan polysaccharide components, has shown a nephroprotective effect in an experimental model of diabetic nephropathy. Although sulodexide reduced albuminuria in patients with type 1 and type 2 diabetes, long-term effects in patients with type 2 diabetes with significant proteinuria have not been established. Objectives. The study was aimed at investigating the effects of sulodexide on proteinuria and renal function in patients with type 2 diabetes and nephropathy. Methods. Fifty-two patients with proteinuria between 500 and 3000 mg/day received sulodexide 200 mg/day for 12 months, while 56 matched patients with type 2 diabetes constituted the control group. All patients received standard metabolic and blood pressure controls. Primary outcome was evaluated as percentage of reduced proteinuria compared with the control group. Renal function was assessed using estimated glomerular filtration rate (GFR). Results. Proteinuria significantly increased in the control group [0.9 (IQR 0.3 to 1.78) to 1.16 (IQR 0.44 to 2.23) g/gCr, P=0.001], whereas it remained stable in the sulodexide group [0.66 (IQR 0.23 to 0.67) to 0.67 (IQR 0.17 to 1.51) g/gCr, P=0.108]. At 12 months, proteinuria was higher by 19.4% (IQR 10.3 to 37.6) in the control group while proteinuria was lower by -17.7% (IQR -53.1 to 3.2) in the sulodexide group with a significant difference between groups (P=0.001). Renal function was noted as a change of estimated GFR, and serum creatinine decreased significantly during the study in both groups but did not significantly differ between groups. No significant changes in the blood pressure, fasting plasma glucose, and hemoglobin A1C were reported. Conclusion. In addition to standard treatment, sulodexide is efficient in maintaining proteinuria in patients with type 2 diabetes with nonnephrotic range proteinuria, but it did not provide an additional benefit concerning renal disease progression.

scholarly journals Association of Wrist Circumference and Waist-to-Height Ratio with Cardiometabolic Risk Factors among Type II Diabetics in a Ghanaian Population

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Christian Obirikorang ◽  
Yaa Obirikorang ◽  
Emmanuel Acheampong ◽  
Enoch Odame Anto ◽  
Emmanuel Toboh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiometabolic Risk ◽  
Cardiometabolic Risk Factors ◽  
Risk Scores ◽  
Diabetic Patients ◽  
Height Ratio ◽  
Significant Difference ◽  
Wrist Circumference ◽  
Waist To Height Ratio

The study determined the association of wrist circumference (WrC) and waist-to-height ratio (WHtR) with cardiometabolic risk factors among diabetics in a Ghanaian population. This cross-sectional study involved 384 diabetic patients at Begoro District Hospital, Ghana. Blood pressure, anthropometrics, and biochemical indices were measured. The overall prevalence of dyslipidaemia, metabolic syndrome (MetS), and hypertension was 42.4%, 76.3%, and 39.8%, respectively. The optimum cut-off range of WrC to identify individuals at increased cardiometabolic risk was 17.5 to –17.8 cm for men and 16.0 to 16.7 cm for women while that of WHtR was 0.52 to 0.61 for men and 0.53 to 0.59 for women. WrC for women was a significant independent predictor for MetS [aOR = 3.0 (1.39–6.72), p=0.005] and systolic blood pressure [aOR = 2.08 (1.17–3.68), p=0.012]. WHtR was a significant positive predictor for triglycerides [aOR = 3.23 (0.10–3.82), p=0.001] for women. Using Framingham risk scores, 61% of the subjects had elevated 10-year risk of developing cardiovascular diseases (CVDs), with no significant difference in gender prevalence. WrC [aOR = 6.13 (0.34–111.4), p=0.107] and WHtR [aOR = 2.52 (0.42–15.02), p=0.309] were associated with statistically insignificant increased odds of moderate-to-high risk of developing CVDs in 10 years. The use of gender-specific cut-offs for WrC and WHtR may offer putative markers for early identification of CRFs.

scholarly journals Telemedicine application in patient with Diabetes, Hypertension and Rheumatoid arthritis：A systematic review and meta-analysis

2021 ◽  
Author(s):  
Yue Ma ◽  
Yan Zhao ◽  
Chongbo Zhao ◽  
Jiahong Lu ◽  
Hong Jiang ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systematic Review ◽  
Blood Pressure ◽  
Chronic Disease ◽  
Quality Assessment ◽  
Meta Analysis ◽  
Glycosylated Hemoglobin ◽  
Fasting Blood Glucose ◽  
Term Care ◽  
Significant Difference

Abstract Background: Under the global epidemic condition，the telemedicine was widely used in the world, especially in the period of long-term care and treatment. The aim of study is to verify the effectiveness of telemedicine in the management of chronic disease by using scientific methods such as hypertension, diabetes, rheumatoid arthritis by using Meta-analysis and systematic review methods. The purpose of this study was to systematic review of the effect of telemedicine in chronic disease, so as to provide inspiration for chronic disease management in the future.Methods: Article searching were performed using Web of Science, PubMed, MEDLINE, EMBASE and other library or database to retrieve articles which published from database and library establishment to October 31st, 2020. Literature quality assessment, systematic review and Meta-analysis were then performed.Results: 12 articles were included in the literature quality assessment (7 diabetes,3 hypertensions,2 rheumatoid arthritis), the article included in this study is of high quality. There are 7 articles included in the Meta-analysis, the result shows there have effect in glycosylated hemoglobin after 12 months of intervention (95%CI=-1.53, -0.16; Z=2.42; P=0.02), compare with 6 months (95%CI=-1.32, -0.01; Z=1.99; P=0.05). It also showed that there was no significant difference in fasting blood glucose after 6 months of intervention (95%CI=-1.19,0.21; Z=1.37; P=0.17). Both systolic blood pressure (95%CI=-12.79, -3.69; Z=3.55; P= 0.0004) and diastolic blood pressure (95%CI=-9.90, -0.43; Z=2.14; P= 0.03) showed statistically significant. Moreover, we also found positive influence of telemedicine about good behaviors and rehabilitation for rheumatoid arthritis patients.Conclusion: The results showed that telemedicine had a positive effect on the management of diabetes, hypertension and rheumatoid arthritis, especially on the management of glycosylated hemoglobin and blood pressure. Telemedicine technologies have great promotion to access the medical services and improve the quality of care, especially for people with chronic diseases.

scholarly journals Telemedicine application in patient with Diabetes, Hypertension and Rheumatoid arthritis: A systematic review and meta-analysis

2021 ◽  
Author(s):  
Yue Ma ◽  
Yan Zhao ◽  
Chongbo Zhao ◽  
Jiahong Lu ◽  
Hong Jiang ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systematic Review ◽  
Blood Pressure ◽  
Chronic Disease ◽  
Quality Assessment ◽  
Meta Analysis ◽  
Glycosylated Hemoglobin ◽  
Fasting Blood Glucose ◽  
Term Care ◽  
Significant Difference

Abstract Background: Under the global epidemic condition，the telemedicine was widely used in the world, especially in the period of long-term care and treatment. The aim of study is to verify the effectiveness of telemedicine in the management of chronic disease by using scientific methods such as hypertension, diabetes, rheumatoid arthritis by using Meta-analysis and systematic review methods. The purpose of this study was to systematic review of the effect of telemedicine in chronic disease, so as to provide inspiration for chronic disease management in the future.Methods: Article searching were performed using Web of Science, PubMed, MEDLINE, EMBASE and other library or database to retrieve articles which published from database and library establishment to October 31st, 2020. Literature quality assessment, systematic review and Meta-analysis were then performed.Results: 12 articles were included in the literature quality assessment (7 diabetes,3 hypertensions,2 rheumatoid arthritis), the article included in this study is of high quality. There are 7 articles included in the Meta-analysis, the result shows there have effect in glycosylated hemoglobin after 12 months of intervention (95%CI=-1.53, -0.16; Z=2.42; P=0.02), compare with 6 months (95%CI=-1.32, -0.01; Z=1.99; P=0.05). It also showed that there was no significant difference in fasting blood glucose after 6 months of intervention (95%CI=-1.19,0.21; Z=1.37; P=0.17). Both systolic blood pressure (95%CI=-12.79, -3.69; Z=3.55; P= 0.0004) and diastolic blood pressure (95%CI=-9.90, -0.43; Z=2.14; P= 0.03) showed statistically significant. Moreover, we also found positive influence of telemedicine about good behaviors and rehabilitation for rheumatoid arthritis patients.Conclusion: The results showed that telemedicine had a positive effect on the management of diabetes, hypertension and rheumatoid arthritis, especially on the management of glycosylated hemoglobin and blood pressure. Telemedicine technologies have great promotion to access the medical services and improve the quality of care, especially for people with chronic diseases.

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