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Contrary to popular belief, telehealth is not a new phenomenon; for many centuries, humankind has sought medical help remotely. In Ancient Rome and Greece, people who were unable to travel to temples to seek medical attention sent messengers with details of their symptoms with the expectation that they would return with advice about the diagnosis and treatment. The development of the telephone expanded the potential for remote healthcare and, indeed,AlexanderGrahamBell, the inventor of the telephone, is reported to have asked for help fromhis assistant after he spilt acid onhis trousers. In 1879, the Lancet published the first case history of a child whose condition was diagnosed successfully over the telephone in the middle of the night. The potential for reducing face-to-face clinical contact was considered as the Lancet discussed how the telephone could obviate the need for unnecessary house visits. The advent of the internet and the rapid adoption of portable devices including laptops, tablets and mobile phones in everyday life has transformed the ability to deliver telehealth. Today in March 2019, 4.3 billion people (55.6% of the world’s population) have access to the internet, while in Europe and North America, internet coverage is enjoyed by 80–95% of the population. In 2016, two-thirds of the global population owned a mobile phone and, by the end of 2019, the number of mobile phone users is forecast to pass five billion, with around half this number possessing a smartphone. Over 36% of the world’s population use a smartphone, up from about 10% in 2011. Although face-to-face consultations are likely to remain the bedrock of clinical care, the opportunities to provide a more flexible and convenient service through telehealth now seem possible and are increasingly being adopted. As a chronic condition, with its demands for self-management, diabetes may be particularly well suited to telehealth. A recent systematic review of seven studies assessing the effectiveness of telehealth on self-management of diabetes control in primary healthcare settings showed positive effects for diabetes self-management in the short term and a fall in HbA1c levels [1]. In this month’s issue of Diabetic Medicine, we have three papers that assessed different aspects of telehealth, two with positive effects and one with a neutral effect. The first is a systematic review of patient decision aids, which are designed to help people make better choices about healthcare. These may be used remotely or during a consultation and may be computeror paper-based. Previous studies in other conditions have shown that patient decision aids improve knowledge, risk perception, satisfaction and shared decision-making. Karagiannis et al. [2] have brought together the findings of 15 randomized controlled trials assessing the effect of decision aids on a variety of outcomes for people with Type 2 diabetes. Decision aids improved the quality of and active participation in decision-making and knowledge transfer; however, there was no effect on glycaemic control or medication taking. Healthcare professionals have used text messaging to support young people with diabetes for a number of years. Over a decade ago, Franklin et al. [3] reported that Sweet Talk, a text-messaging support system, improved self-efficacy and medication taking, but did not improve glycaemic control. In this month’s issue, McGill et al. [4] report the results of an 18-month text-messaging intervention in teenagers with Type 1 diabetes. The participants received text reminders to check blood glucose levels and reply with their results. Over the trial period, nearly half the teenagers responded with at least one blood glucose result on more than half of the days. Regardless of baseline HbA1c, these individuals experienced better glycaemic control than those who did not engage with the service. Texting appeared to be an acceptable means of engaging teenagers, but we need further work to understand how to maintain interest in the long term. The third study assessed the benefit of TeleCare support in people with Type 2 diabetes [5]. Participants were randomized to structured self-monitoring of blood glucose with or without additional monthly telephone consultations with a trained nurse compared with usual diabetes care. HbA1c levels fell in both intervention groups over the 12-month Cover image: Young woman with coffee texting on urban pavement Credit: CAIA IMAGE/SCIENCE PHOTO LIBRARY.