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Men, black communities and the poorly educated are experiencing significant disparities in accessing game-changing digital health care for type 2 diabetes, data scientists from The University of Manchester show.

The peer-reviewed meta-analysis of 16 studies involving 71, 336 patients from the U.S., U.K., and the Netherlands published in the Journal of Medical Internet Research, is a wake-up call to policy makers grappling with escalating numbers affected by the disease.

"Our study provides evidence of significant disparities in telemedicine use for type 2 diabetes among men, black communities and those with lower levels of education, " said Nawwarah Alfarwan, a Ph.D. researcher and lead author of the study. "These groups already face many challenges in accessing essential health care services.

"Every 10 seconds, somebody dies from diabetes-related complications worldwide, most of whom have type 2 diabetes, so policymakers really need to think about how to improve access to this crucial form of health care."

Telemedicine has revolutionized the management of type 2 diabetes in primary care by improving access to health care services, and consequently health outcomes.

Comprising a range of technology including virtual consultations, wearable devices, mobile health apps and other technologies, health services have successfully used it as a response to the increasing prevalence of the disease.

Data from five studies, comprising 59, 609 patients, showed patients with higher education levels had 68.1% greater odds of using telemedicine than those with lower education levels.

The less educated, say the researchers, have lower levels of digital and health literacy, and are more likely to have concerns about trust and privacy.

Ten of the studies, comprising 68, 355 patients, showed female patients had a 5% higher chance of using telemedicine than men.

The difference can be explained, say the researchers, by women being more actively engaged with health care services not only for themselves but also their family.

Existing epidemiological evidence, they add, suggests men have lower help-seeking behavior, stronger preferences for in-person consultations, or lower levels of digital health literacy.

Five of the studies showed that compared to white patients, black patients were 45% less likely to use telemedicine.

Many people within black communities, the researchers argue, have limited access to digital infrastructure, mistrust in health care systems, language barriers, and inadequate insurance coverage or digital literacy support.

And 10 of the studies, comprising 47, 927 patients, showed older patients were 2.1% less likely to use telemedicine than younger patients.

Co-author Professor Maria Panagioti, also from The University of Manchester, added, "For patients with type 2 diabetes, we show the extent of the digital divide in certain demographics, especially those from minority backgrounds.

"Lack of affordable access to computers, smartphones, and lower levels of digital and health literacy all contribute to these inequalities.

"By understanding these disparities and addressing the underlying factors, policymakers could make more inclusive and effective telemedicine interventions.

"They should also consider targeted strategies to improve engagement among men, such as awareness campaigns and tailored interventions."

More information: Nawwarah Alfarwan et al, Demographic and Socioeconomic Disparities in Telemedicine Use Among Individuals With Type 2 Diabetes in Primary Care: Systematic Review and Meta-Analysis, Journal of Medical Internet Research (2025). DOI: 10.2196/73113  Journal information: Journal of Medical Internet Research