European Journal of Pediatrics

, Volume 165, Issue 10, pp 701–705

Telemedical support to improve glycemic control in adolescents with type 1 diabetes mellitus

  • Birgit Rami
  • Christian Popow
  • Werner Horn
  • Thomas Waldhoer
  • Edith Schober
Original Paper

Abstract

Introduction

In this paper, we evaluated the feasibility of a telemedical (TM) support program and its effect on glycemic control in adolescents with type 1 diabetes mellitus (T1DM). Thirty-six adolescents (m=20, median age at the start of the study: 15.3 years (range: 10.7–19.3 years), median age at diagnosis: 9.3 years (2.1–13.8 years), median duration of disease: 6.4 years (1.0–12.8 years), HbA1c>8%, all on intensified insulin therapy) were randomized in a crossover trial over 6 months (3 months with TM, 3 months with conventional support and paper diary (PD)). During the TM phase, the patients sent their data (date, time, blood glucose, carbohydrate intake, insulin dosage) via mobile phone, at least daily, to our server and diabetologists sent back their advice via short message service (SMS) once a week.

Results

Glycemic control improved during the TM phase, while it deteriorated during the PD phase: TM-PD group HbA1c (%, median (range)): 9.05 (8–11.3) (at 0 months), 8.9 (6.9–11.3) (at 3 months), and 9.2 (7.4–12.6) (at 6 months), and PD-TM group: 8.9 (8.3–11.6), 9.9 (8.1–11), and 8.85 (7.3–11.7) (p<0.05). Patients rated the TM support program to be a good idea. Technical problems with General Packet Radio Service (GPRS) data transmission led to data loss and decreased patient satisfaction.

Conclusion

Our telemedical support program, VIE-DIAB, proved to be feasible in adolescents and helped to improve glycemic control.

Keywords

Type 1 diabetes mellitus Glycemic control Telemedicine Adolescents 

Abbreviations

T1DM

Type 1 diabetes mellitus

TM

Telemedicine/telemedical

PD

Paper diary

BMI

Body mass index

DCCT

The Diabetes Control and Complications Trial

SMS

Short message service

GPRS

General Packet Radio Service

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Birgit Rami
    • 1
  • Christian Popow
    • 2
  • Werner Horn
    • 3
    • 4
  • Thomas Waldhoer
    • 5
  • Edith Schober
    • 1
  1. 1.Department of Pediatrics and Adolescent MedicineMedical University of ViennaViennaAustria
  2. 2.Department of Child and Adolescent PsychiatryMedical University of ViennaViennaAustria
  3. 3.Department of Medical Cybernetics and Artificial IntelligenceMedical University of ViennaViennaAustria
  4. 4.Austrian Research Institute for Artificial Intelligence (ÖFAI)ViennaAustria
  5. 5.Cancer Research Institute, Department of EpidemiologyMedical University of ViennaViennaAustria

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