دورية أكاديمية

Telemedicine and type 1 diabetes: Is technology per se sufficient to improve glycaemic control?

التفاصيل البيبلوغرافية
العنوان: Telemedicine and type 1 diabetes: Is technology per se sufficient to improve glycaemic control?
المؤلفون: Franc, S., Borot, S., Ronsin, O., Quesada, J.-L., Dardari, D., Fagour, C., Renard, E., Leguerrier, A.-M., Vigeral, C., Moreau, F., Winiszewski, P., Vambergue, A., Mosnier-Pudar, H., Kessler, L., Reffet, S., Guerci, B., Millot, L., Halimi, S., Thivolet, C., Benhamou, P.-Y.
المصدر: Diabetes & Metabolism; Feb2014, Vol. 40 Issue 1, p61-66, 6p
مستخلص: Abstract: Aim: In the TELEDIAB-1 study, the Diabeo system (a smartphone coupled to a website) improved HbA1c by 0.9% vs controls in patients with chronic, poorly controlled type 1 diabetes. The system provided two main functions: automated advice on the insulin doses required; and remote monitoring by teleconsultation. The question is: how much did each function contribute to the improvement in HbA1c? Methods: Each patient received a smartphone with an insulin dose advisor (IDA) and with (G3 group) or without (G2 group) the telemonitoring/teleconsultation function. Patients were classified as “high users” if the proportion of “informed” meals using the IDA exceeded 67% (median) and as “low users” if not. Also analyzed was the respective impact of the IDA function and teleconsultations on the final HbA1c levels. Results: Among the high users, the proportion of informed meals remained stable from baseline to the end of the study 6months later (from 78.1±21.5% to 73.8±25.1%; P =0.107), but decreased in the low users (from 36.6±29.4% to 26.7±28.4%; P =0.005). As expected, HbA1c improved in high users from 8.7% [range: 8.3–9.2%] to 8.2% [range: 7.8–8.7%] in patients with (n =26) vs without (n =30) the benefit of telemonitoring/teleconsultation (−0.49±0.60% vs −0.52±0.73%, respectively; P =0.879). However, although HbA1c also improved in low users from 9.0% [8.5–10.1] to 8.5% [7.9–9.6], those receiving support via teleconsultation tended to show greater improvement than the others (−0.93±0.97 vs −0.46±1.05, respectively; P =0.084). Conclusion: The Diabeo system improved glycaemic control in both high and low users who avidly used the IDA function, while the greatest improvement was seen in the low users who had the motivational support of teleconsultations. [Copyright &y& Elsevier]
Copyright of Diabetes & Metabolism is the property of Masson Editeur and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
قاعدة البيانات: Supplemental Index
الوصف
تدمد:12623636
DOI:10.1016/j.diabet.2013.09.001