Transfer of knowledge from the specialist to the generalist by videoconferencing: effect on diabetes care.

We conducted a 12-month prospective interventional study of videoconferencing between primary and secondary care. A treatment network consisting of a diabetes specialist and four general practitioners was established. The communications medium was PC-based videoconferencing via ISDN at 128 kbit/s. A total of 154 type 2 diabetic patients entered the study. The specialist was contacted 94 times via videoconferencing. Metabolic and haemodynamic parameters were significantly improved over the course of the study: the mean HbA1c level fell from 8.1% to 7.8%, systolic blood pressure from 156 to 148 mmHg and diastolic blood pressure from 88 to 83 mmHg. The study demonstrated that therapeutic counselling by videoconferencing is feasible in diabetes care and suggests that it reduces hospital admissions and improves the quality of care.