Endocrine Abstracts

Aim: Primary goal was to determine whether the improvement of HbA1c, observed in inefficiently insulin-treated diabetes mellitus (DM) patients on a telemonitoring system, had a lasting effect following its discontinuation.

Methods: Forty-seven DM patients (mean age 56.15±15.86 years, mean BMI 29.44±6.69 kg/m², mean HbA1c 9.9±2.62%) and 25 insulin-treated matched controls (mean age 56.16±20.11 years, mean BMI 27.6±5.18 kg/m², mean HbA1c 9.92±2.45%) were enrolled. Patients’ participation criteria included insufficient control of DM, distance from specialized medical facilities or recent hospitalization for DM. Data were transmitted from the glucose-meters to our computers via modem. Communication with the patients was achieved with e-mails and mobile-phone text messages through integrated software (Telemedicor). HbA1c and BMI were evaluated at enrollment, 3 and 6 months, as well as 6 months after discontinuation of the telemonitoring.

Results: A significant reduction in HbA1c was observed at 3 (6.93±0.88% in patients vs 8.04±0.87% in controls, P<0.0001) and 6 months (6.78±0.84% in patients vs 7.81±1.06% in controls, P<0.0001). Compared to controls, significant reduction was also observed in the group of patients with an initial HbA1c>10% (3 months: 6.83±1.06 vs 8.45±0.87%, and 6 months: 6.7±1 vs 8.17±1.21%) and HbA1c<10% (3 months: 7.02±0.67 vs 7.72±0.75%, and 6 months: 6.86±0.65 vs 7.52±0.86%). No statistical differences in BMI were observed between patients and controls.

Six months after discontinuation of the telemonitoring, patients’ HbA1c levels deteriorated (7.25±1.02 P<0.0001). Significant increase was observed in both groups of patients with HbA1c>10% (7.35±1.35 P=0.001) and HbA1c<10% (7.17±0.62, P=0.006).

Conclusions: Telemonitoring DM patients can result in improved compliance especially in patients with HbA1c>10%. This is reflected in the reduction of HbA1c levels compared to the controls. Visits of outpatient departments are reduced, resulting in lower cost and less patient inconvenience. This beneficial effect is blunted 6 months after terminating the intervention.