Telemedical support to improve glycemic control in adolescents with type 1 diabetes mellitus
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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.
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.
Our telemedical support program, VIE-DIAB, proved to be feasible in adolescents and helped to improve glycemic control.
KeywordsType 1 diabetes mellitus Glycemic control Telemedicine Adolescents
Type 1 diabetes mellitus
Body mass index
The Diabetes Control and Complications Trial
Short message service
General Packet Radio Service
This project was, in part, sponsored by Telecom Austria.
- 1.American Diabetes Association (1999) Clinical practice recommendations. Diabetes Care 22(Suppl 1):S35Google Scholar
- 5.d’Annunzio G, Belazzi R, Larizza C, Montani S, Pennati C, Castelnovi C, Stefanelli M, Rondini G, Lorini R (2003) Telemedicine in the management of young patients with type 1 diabetes mellitus: a follow-up study. Acta Biomed Ateneo Parmese 74(Suppl 1):49–55Google Scholar
- 9.Holl RW, Swift PG, Mortensen HB, Lynggaard H, Hougaard P, Aanstoot HJ, Chiarelli F, Daneman D, Danne T, Dorchy H, Garandeau P, Greene S, Hoey HM, Kaprio EA, Kocova M, Martul P, Matsuura N, Robertson KJ, Schoenle EJ, Sovik O, Tsou RM, Vanelli M, Aman J (2003) Insulin injection regimens and metabolic control in an international survey of adolescents with type 1 diabetes over 3 years: results from the Hvidore study group. Eur J Pediatr 162(1):22–29PubMedCrossRefGoogle Scholar
- 13.SAS Institute (1999) SAS/STAT user’s guide, version 8. SAS Institute Inc., Cary, North CarolinaGoogle Scholar