Skip to main content

Advertisement

SpringerLink
Log in

Teleconsultation in type 1 diabetes mellitus (TELEDIABE)

  • Original Article
  • Published:
Acta Diabetologica Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Abbreviations

ICT:

Information and communications technology

DM:

Diabetes mellitus

CSII:

Continuous subcutaneous insulin infusion

MDI:

Multiple dose insulin

References

  1. Farmer A, Gibson OJ, Tarassenko L, Neil A (2005) A systematic review of telemedicine interventions to support blood glucose self-monitoring in diabetes. Diabet Med 22:1372–1378

    Article  CAS  PubMed  Google Scholar 

  2. Montori VM, Helgemoe PK, Guyatt GH et al (2004) Telecare for patients with type 1 diabetes and inadequate glycemic control: a randomized controlled trial and meta-analysis. Diabetes Care 27:1088–1094

    Article  PubMed  Google Scholar 

  3. Shulman RM, O’Gorman CS, Palmert MR (2010) The impact of telemedicine interventions involving routine transmission of blood glucose data with clinician feedback on metabolic control in youth with type 1 diabetes: a systematic review and meta-analysis. Int J Pediatr Endocrinol 2010:536957

    Article  PubMed  PubMed Central  Google Scholar 

  4. El-Gayar O, Timsina P, Nawar N, Eid W (2013) A systematic review of IT for diabetes self-management: are we there yet? Int J Med Inform 82:637–652

    Article  PubMed  Google Scholar 

  5. Holtz B, Lauckner C (2012) Diabetes management via mobile phones: a systematic review. Telemed J e-Health 18:175–184

    Article  PubMed  Google Scholar 

  6. Guljas R, Ahmed A, Chang K (2014) Whitlock a impact of telemedicine in managing type 1 diabetes among school-age children and adolescents: an integrative review. J Pediatr Nurs 29:198–204

    Article  PubMed  Google Scholar 

  7. Raymond JK, Berget CL, Driscoll K, Ketchum K, Cain C, Thomas F (2016) CoYoT1 clinic: innovative telemedicine care model for young adults with type 1 diabetes. Diabete Technol Ther 18:385–391

    Article  Google Scholar 

  8. Marcolino MS, Maia JX, Alkmim MB, Boersma E, Ribeiro AL (2013) Telemedicine application in the care of diabetes patients: systematic review and meta-analysis. PLoS ONE 8:e79246

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Shea S, Kothari D, Teresi JA et al (2013) Social impact analysis of the effects of a telemedicine intervention to improve diabetes outcomes in an ethnically diverse, medically underserved population: findings from the IDEATel Study. Am J Public Health 103:1888–1894

    Article  PubMed  PubMed Central  Google Scholar 

  10. Carter EI, Nunlee-Bland G, Callender C (2011) A patient centric, provider assisted diabetes telehealth self management intervention for urban minorities. Perspesct Health Inf Manage 8:1b

    Google Scholar 

  11. Whittemore R, Jaser SS, Faulkner MS, Murphy K, Delamater A, Grey M (2013) TEENCOPE Research Group. Type 1 diabetes eHealth psychoeducation: youth recruitment, participation, and satisfaction. J Med Internet Res 15:e15

    Article  PubMed  PubMed Central  Google Scholar 

  12. Kempf K, Altpeter B, Berger J et al (2017) Efficacy of the telemedical lifestyle intervention program TeLiPro in advanced stages of type 2 diabetes: a randomized controlled trial. Diabetes Care 40(7):863–871

    Article  PubMed  Google Scholar 

  13. So CF, Chung J (2017) Telehealth for diabetes self-management in primary healthcare—a systematic review and meta-analysis. J Telemed Telecare 1:1357633X17700552

    Google Scholar 

  14. Porter J, Huggins CE, Truby H, Collins J (2016) The effect of using mobile technology-based methods that record food or nutrient intake on diabetes control and nutrition outcomes: a systematic review. Nutrients 8(12):815

    Article  PubMed Central  Google Scholar 

  15. Viana L, Gomes M, Zajdenverg L, Pavin E, Azevedo M (2016) Brazilian Type 1 Diabetes Study Group interventions to improve patients’ compliance with therapies aimed at lowering glycated hemoglobin (HbA1c) in type 1 diabetes: systematic review and meta-analyses of randomized controlled clinical trials of psychological, telecare, and educational interventions. Trials 17:94

    Article  PubMed  PubMed Central  Google Scholar 

  16. Toma T, Athanasiou T, Harling L, Darzi A, Ashrafian H (2014) Online social networking services in the management of patients with diabetes mellitus: systematic review and meta-analysis of randomised controlled trials. Diabetes Res Clin Pract 106:200–211

    Article  PubMed  Google Scholar 

  17. Su D, Zhou J, Kelley MS et al (2016) Does telemedicine improve treatment outcomes for diabetes? A meta-analysis of results from 55 randomized controlled trials. Diabetes Res Clin Prac 116:136–148

    Article  Google Scholar 

  18. Verbeke G, Molenberghs G (2000) Linear mixed models for longitudinal data. Springer, New York

    Google Scholar 

  19. Wojcicki J, Ladyzynski P, Foltynski P (2013) What we can really expect from telemedicine in intensive diabetes treatment: 10 years later. Diabetes Technol Ther 15:3

    Article  Google Scholar 

  20. Faruque L, Wiebe N, Ehteshami-Afshar A et al (2017) Alberta kidney disease network effect of telemedicine on glycated hemoglobin in diabetes: a systematic review and meta-analysis of randomized trials. CMAJ 189(9):E341–E364

    Article  PubMed  PubMed Central  Google Scholar 

  21. Liu W, Saxon DR, McNair B, Sanagorski R, Rasouli N (2016) Endocrinology telehealth consultation improved glycemic control similar to face-to-face visits in veterans. J Diabetes Sci Technol 10:1079–1086

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Landau Z, Mazor-Aronovitch K, Boaz M et al (2010) The effectiveness of Internet-based blood glucose monitoring system on improving diabetes control in adolescent with type 1 diabetes. Pediatr Diabetes 13:203–207

    Article  Google Scholar 

  23. Rossi MC, Nicolucci A, Lucisano G et al (2013) Impact of the “diabetes interactive diary” telemedicine system on metabolic control, risk of hypoglycemia and quality of life: a randomized trial in type 1 diabetes. Diabetes Technol Ther 15:670–679

    Article  CAS  PubMed  Google Scholar 

  24. Pressman AR, Kinoshita L, Kirk S, Barbosa GM, Chou C, Minkoff J (2014) A novel telemonitoring device for improving diabetes control: protocol and results from a randomized clinical trial. Telemed e-Health 20:109–114

    Article  Google Scholar 

  25. Boyle L, Grainger R, Hall RM, Krebs JD (2017) Use of and beliefs about mobile phone apps for diabetes self-management: surveys of people in a hospital diabetes clinic and diabetes health professionals in New Zealand. JMIR Mhealth Uhealth 5(6):e85

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Diabetology Unit, ASST Grande Ospedale Metropolitano Niguarda, P.zza Ospedale Maggiore 3, 20162, Milan, Italy

    Federico Bertuzzi & Basilio Pintaudi

  2. Medicine Department, Legnano ASST Ovest Milanese, Legnano, Italy

    Ilario Stefani, Benedetta Rivolta & Antonino Mazzone

  3. SS Diabetologia, Bassini Hospital, Cinisello Balsamo, Milan, Italy

    Elena Meneghini

  4. Metabolism Research Center and Endocrinology and Metabolism, IRCCS Policlinico San Donato Milanese, Milan, Italy

    Livio Luzi

  5. Department of Biomedical and Health Sciences, University of Milan, Milan, Italy

    Livio Luzi

Authors
  1. Federico Bertuzzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ilario Stefani
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Benedetta Rivolta
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Basilio Pintaudi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Elena Meneghini
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Livio Luzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Antonino Mazzone
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Federico Bertuzzi.

Ethics declarations

Conflict of interest

The authors declare no conflict of interest.

Ethical approval

This study was approved by the ethics committee (Comitato Etico Milano Area C) (Ethics code: *535-B-102014).

Informed consent

Written informed consents were obtained from all participants.

Additional information

Managed by Antonio Secchi.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bertuzzi, F., Stefani, I., Rivolta, B. et al. Teleconsultation in type 1 diabetes mellitus (TELEDIABE). Acta Diabetol 55, 185–192 (2018). https://doi.org/10.1007/s00592-017-1084-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00592-017-1084-9

Keywords

Search

Navigation