Endocrine Abstracts

Objective: Our purpose was to evaluate the impact of a transmission system on metabolic control of patients with diabetes.

Research design and methods: This ongoing-prospective, randomized, comparative study included adult patients with type 1 (n=71) and type 2 diabetes (n=139). Consecutive patients were equally allocated into two groups. Both groups received routine care by the same health care professionals (HCPs) 3-monthly. TeleDiab group additionally transmissed SMBG data and received feedbacks and SMSs regularly.

Results: We reviewed metabolic parameters based on mean difference from baseline to 9 months. In TeleDiab group, fasting blood glucose (FBG: −19 mg/dl, P=0.089), HbA1c (0.6%, P<0.001), HDL-cholesterol (−3.6 mg/dl, P=0.006), systolic (SBP: −5.3 mmHg, P=0.001), and diastolic blood pressures (DBP: −2.7 mmHg, P=0.055) remarkably reduced from baseline. While in control group HbA1c (−0.4%, P=0.004) only reduced but BMI (0.6 kg/m², P=0.014) increased significantly; additionally, SBP (−2.8 mmHg, P=0.099) and DBP (−2.4 mmHg, P=0.079) tended to decrease tended to increase from baseline.

In TeleDiab group, we observed positive correlations between average number of SMBG and change from baseline to 9 months FBG (monthly post-prandial: r=0.256, P=0.029) and weight (daily post-prandial: r=0.229, P=0.049); and negative correlations between average number of SMBG and change from baseline to 9 months HDL-cholesterol (daily postprandial: r=−0.261, P=0.026), SBP (weekly total: r=−0.276, P=0.017; weekly pre-prandial: r=−0.233, P=0.046; monthly total: r=−0.272, P=0.019; monthly pre-prandial: r=−0.247, P=0.034; and monthly post-prandial: r=−0.247, P=0.035), and DBP (weekly post-prandial: r=−0.284, P=0.044; monthly total: r=−0.234, P=0.044; and monthly post-prandial: r=−0.316, P=0.006). At 9-month, more patients with type 2 diabetes in TeleDiab group achieved optimal HbA1c as compared with control group (52.1% vs 38.3%, P=0.061).

Conclusion: Regular follow-up visits by the same HCPs resulted with improved glycaemic, lipid and BP control in subjects with diabetes. However, further improvement was achieved with the use of electronic transmission system.

Disclosure: This work is partly supported by Turkcell Telecommunication Company (2904/2012).