Federico Bertuzzi1, Ilario Stefani2, Benedetta Rivolta2, Basilio Pintaudi3, Elena Meneghini4, Livio Luzi5,6, Antonino Mazzone2. 1. Diabetology Unit, ASST Grande Ospedale Metropolitano Niguarda, P.zza Ospedale Maggiore 3, 20162, Milan, Italy. federico.bertuzzi@ospedaleniguarda.it. 2. Medicine Department, Legnano ASST Ovest Milanese, Legnano, Italy. 3. Diabetology Unit, ASST Grande Ospedale Metropolitano Niguarda, P.zza Ospedale Maggiore 3, 20162, Milan, Italy. 4. SS Diabetologia, Bassini Hospital, Cinisello Balsamo, Milan, Italy. 5. Metabolism Research Center and Endocrinology and Metabolism, IRCCS Policlinico San Donato Milanese, Milan, Italy. 6. Department of Biomedical and Health Sciences, University of Milan, Milan, Italy.
Abstract
AIMS: The growing incidence of diabetes and the need to contain healthcare costs empower the necessity to identify new models of care. Telemedicine offers an acknowledged instrument to provide clinical health care at a distance, increasing patient compliance and the achievement of therapeutical goals. The objective was to test the feasibility and the efficacy in the improvement of the glycemic control of the teleconsultation for patients with type 1 diabetes mellitus. METHODS: A randomized open-label, parallel arms, controlled trial was conducted in two diabetes centers in Italy. Participants affected by type 1 diabetes mellitus have been randomly (1:1) assigned to receive their visits as standard or a web-based care. Patients in the teleconsultation group can arrange their appointments on a Web site and can also have access to web educational courses or to nutritional and psychological counseling. The primary outcome was the assessment of glycemic control by HbA1c measurement after a 12-month follow-up. RESULTS: Overall 74 participants were followed for 1 year. HbA1c changes were not statistically different within (p = 0.56 for standard care group; p = 0.45 for telemedicine group) and between (p = 0.60) groups when considering differences from baseline to the end of the study. Patients randomized to teleconsultation reported reduced severe hypoglycemic episodes (p = 0.03). In addition, they were largely satisfied with the activities, perceived a good improvement in the self-management of the diabetes, and reported to have a time saving and a cost reduction. CONCLUSIONS: In conclusion, TELEDIABE proposes a new system for the management of patients with type 1 diabetes mellitus.
RCT Entities:
AIMS: The growing incidence of diabetes and the need to contain healthcare costs empower the necessity to identify new models of care. Telemedicine offers an acknowledged instrument to provide clinical health care at a distance, increasing patient compliance and the achievement of therapeutical goals. The objective was to test the feasibility and the efficacy in the improvement of the glycemic control of the teleconsultation for patients with type 1 diabetes mellitus. METHODS: A randomized open-label, parallel arms, controlled trial was conducted in two diabetes centers in Italy. Participants affected by type 1 diabetes mellitus have been randomly (1:1) assigned to receive their visits as standard or a web-based care. Patients in the teleconsultation group can arrange their appointments on a Web site and can also have access to web educational courses or to nutritional and psychological counseling. The primary outcome was the assessment of glycemic control by HbA1c measurement after a 12-month follow-up. RESULTS: Overall 74 participants were followed for 1 year. HbA1c changes were not statistically different within (p = 0.56 for standard care group; p = 0.45 for telemedicine group) and between (p = 0.60) groups when considering differences from baseline to the end of the study. Patients randomized to teleconsultation reported reduced severe hypoglycemic episodes (p = 0.03). In addition, they were largely satisfied with the activities, perceived a good improvement in the self-management of the diabetes, and reported to have a time saving and a cost reduction. CONCLUSIONS: In conclusion, TELEDIABE proposes a new system for the management of patients with type 1 diabetes mellitus.
Authors: Moshe Phillip; Richard M Bergenstal; Kelly L Close; Thomas Danne; Satish K Garg; Lutz Heinemann; Irl B Hirsch; Boris P Kovatchev; Lori M Laffel; Viswanathan Mohan; Christopher G Parkin; Tadej Battelino Journal: Diabetes Technol Ther Date: 2020-09-28 Impact factor: 6.118
Authors: Sara E Shaw; Gemma Hughes; Joseph Wherton; Lucy Moore; Rebecca Rosen; Chrysanthi Papoutsi; Alex Rushforth; Joanne Morris; Gary W Wood; Stuart Faulkner; Trisha Greenhalgh Journal: Front Digit Health Date: 2021-12-20
Authors: Sara E Shaw; Lucas Martinus Seuren; Joseph Wherton; Deborah Cameron; Christine A'Court; Shanti Vijayaraghavan; Joanne Morris; Satyajit Bhattacharya; Trisha Greenhalgh Journal: J Med Internet Res Date: 2020-05-11 Impact factor: 5.428