Endocrine Abstracts

Introduction: Our goal was to monitor and control the blood glucose levels in inefficiently controlled insulin-treated patients with diabetes mellitus (DM). The target was to achieve an early detection of DM deregulation, to maintain accepted HbA1c levels through active intervention and to minimize the outpatient department visits.

Description of methods/design: Twenty-six insulin-treated type 1 and 2 DM patients were enrolled (mean age 61.42±14.5 years, mean BMI 31.67±7.28 kg/m²). Inclusion criteria were: insufficient control of DM, living far from specialized medical facilities or recent discovery/hospitalization of insulin treated DM. Data transmission from the glucose-meters (FreeStyle Precision and Free Style Freedom Lite, Abbott, Oxon-UK) to the computers of our clinic was done via modem, while storage, documentation and communication with the patients with e-mails or mobile-phone text messages was achieved through a specialized integrated software (Telemedicor, Hertfordshire-UK). Monitoring period was 6 months with measuring of HbA1c levels at enrollment and at 3 and 6 months afterwards.

Results: Statistical analysis (ANOVA) revealed a significant reduction of HbA1c at 3 (9.92±2.79 vs 6.68±0.92% P<0.0001) as well as 6 months (9.92±2.79 vs 6.61±0.88%, P<0.001) from the time of enrollment. The reduction of HbA1c was greater in the group of patients with an initial HbA1c level above 10% at 3 (12.11±2.2 vs 6.65±1.19 P<0.0001) as well at 6 months (12.11±2.2 vs 6.55±1.09 P<0.0001) compared to the group with an initial HbA1c level below 10% at 3 (7.74±0.97 vs 6.70±0.58 P<0.001) and 6 months (7.74±0.97 vs 6.68±0.64 P<0.001).

Conclusions: Telemonitoring DM patients can result in improved compliance due to a more frequent doctor-patient contact. This is reflected in the reduction of HbA1c levels. In addition, a reduction of visits of outpatients department is achieved resulting in lower cost and less patient inconvenience.