Hugh D Tildesley1, Mary Ellen Conway2, Lan Deng3, Augustine M Lee4, Jeremy H M Chan5, Adel B Mazanderani6, Hamish G Tildesley7, Adam S White8, Monika Pawlowska4, Stuart A Ross9. 1. Department of Endocrinology and Metabolism, St. Paul's Hospital, Vancouver, British Columbia, Canada; University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: hdtildesley@gmail.com. 2. McMaster University, Hamilton, Ontario, Canada. 3. McGill University, Montreal, Quebec, Canada. 4. University of British Columbia, Vancouver, British Columbia, Canada. 5. Vanderbilt University, School of Medicine, Nashville, Tennessee, USA. 6. Saint George's University, Grenada, West Indies. 7. Dartmouth College, Hanover, New Hampshire, USA. 8. Department of Endocrinology and Metabolism, St. Paul's Hospital, Vancouver, British Columbia, Canada; University of British Columbia, Vancouver, British Columbia, Canada. 9. University of Calgary, Calgary, Alberta, Canada.
Abstract
OBJECTIVE: To assess the long-term effect of an Internet blood glucose monitoring system (IBGMS) on patients with type 1 diabetes mellitus and patients with type 2 diabetes. METHODS: In all, 1200 patients were offered to be taught to communicate with their endocrinologists using standardized glucose level reports by e-mail, and received feedback within 24 hours. The first 926 patients enrolled were reviewed consecutively from March 2011 to October 2013. Seventy-seven of these patients were excluded owing to lack of glycated hemoglobin (A1C) data. The remaining 849 patients consisted of 295 patients with type 1 diabetes and 554 patients with type 2 diabetes. Nonreporters are patients with no record of reporting (n=167), whereas the reporters had reported at least once (n=682). The A1C values were obtained at registration; follow-up values at 3-month intervals were recommended. RESULTS: Reporter A1C decreased from 8.13%±1.34% to 7.74%±1.11% (p<0.0001). Reporters with type 1 diabetes dropped from 8.04%±1.23% to 7.72%±1.03% (n=238; p<0.0001). Reporters with type 2 diabetes dropped from 8.18%±1.40% to 7.75%±1.14% (n=444; p<0.0001) and were subdivided based on treatment: those on oral hypoglycemic agents declined from 7.96%±1.38% to 7.49%%±1.03% (p<0.0001), and those on insulin with or without oral hypoglycemic agents declined from 8.40%%±1.39% to 8.02%±1.20% (p<0.0001). The nonreporters did not show a significant change in A1C. CONCLUSIONS: Initial and prolonged improvement was found in A1C levels for all reporters. The data support that numerous patients can be followed up effectively using the Internet for as long as 30 months.
OBJECTIVE: To assess the long-term effect of an Internet blood glucose monitoring system (IBGMS) on patients with type 1 diabetes mellitus and patients with type 2 diabetes. METHODS: In all, 1200 patients were offered to be taught to communicate with their endocrinologists using standardized glucose level reports by e-mail, and received feedback within 24 hours. The first 926 patients enrolled were reviewed consecutively from March 2011 to October 2013. Seventy-seven of these patients were excluded owing to lack of glycated hemoglobin (A1C) data. The remaining 849 patients consisted of 295 patients with type 1 diabetes and 554 patients with type 2 diabetes. Nonreporters are patients with no record of reporting (n=167), whereas the reporters had reported at least once (n=682). The A1C values were obtained at registration; follow-up values at 3-month intervals were recommended. RESULTS: Reporter A1C decreased from 8.13%±1.34% to 7.74%±1.11% (p<0.0001). Reporters with type 1 diabetes dropped from 8.04%±1.23% to 7.72%±1.03% (n=238; p<0.0001). Reporters with type 2 diabetes dropped from 8.18%±1.40% to 7.75%±1.14% (n=444; p<0.0001) and were subdivided based on treatment: those on oral hypoglycemic agents declined from 7.96%±1.38% to 7.49%%±1.03% (p<0.0001), and those on insulin with or without oral hypoglycemic agents declined from 8.40%%±1.39% to 8.02%±1.20% (p<0.0001). The nonreporters did not show a significant change in A1C. CONCLUSIONS: Initial and prolonged improvement was found in A1C levels for all reporters. The data support that numerous patients can be followed up effectively using the Internet for as long as 30 months.
Keywords:
IBGMS; Internet blood glucose monitoring system; Internet intervention; SSGI; glycemia control; intervention par internet; online diabetes management; prise en charge en ligne du diabète; régulation de la glycémie; système de surveillance de la glycémie par internet
Authors: Nelson Chow; Daniel Shearer; Jessica Aydin Plaa; Betty Pottinger; Monika Pawlowska; Adam White; Hugh D Tildesley Journal: BMJ Open Diabetes Res Care Date: 2016-04-29