Endocrine Abstracts

Introduction: Telehealth systems have become an alternative method to control chronic illnesses like diabetes. The aim of this study was to evaluate a telehealth system in patients with type 1 diabetes who have an optimized treatment with an insulin pump and real-time continuous glucose monitoring system.

Research design and methods: Prospective, 1-year study of 15 patients with a continuous insulin infusion system and a real time glucose sensor. Three medical visits took place: prebaseline, baseline and at 6 months. Each month the patients sent by telecare platform information about glucose meter, glucose sensor and insulin pump. We adjusted the treatment and returned the information by e-mail. We evaluated psychological and metabolic variables, including HbA1c, hypoglycemia, hyperglycemia, number of controls, glucose variability: S.D., mean amplitude glycemic excursions (MAGE), mean of daily difference (MODD); low blood glucose index (LBGI), high blood glucose index (HBGI), blood glucose risk index (BGRI), GRADE and 8-isoprostanoid F2 α in 24-h urine samples.

Results: The mean age of patients at the start was 40.46±8.40 years and the mean evolution of diabetes of 21.92±6.26 years. There was a reduction in HbA1c (7.50±0.49 vs 6.97±0.59; P<0.05), an increase in the number of self-monitoring blood glucose controls per day (5.19±1.97 vs 6.18±1.97; P=0.034), and an improvement in variability: MODD (67.3±44.40 vs. 53.1±40.69; P<0.05) and MAGE (136.3±44.40 vs 102.4±40.69; P<0.05). Psychological results: improvement in quality of life (92.38±17.46 vs. 86.92±18.07; P=0.012), satisfaction with the treatment (34.2±6.4 vs. 31.5±7.5; P=0.02) and less fear of hypoglycemia (35.6±10.1 vs. 31.5±10.9; P=0.018).

Conclusion: Telemedicine resulted in an improvement in metabolic control, glucose variability and quality of life of patients with type 1 diabetes treated with sensor and insulin pump.