Acta Diabetologica

, Volume 51, Issue 2, pp 247–256

Using the Internet-based upload blood glucose monitoring and therapy management system in patients with type 1 diabetes

  • S. Shalitin
  • T. Ben-Ari
  • M. Yackobovitch-Gavan
  • A. Tenenbaum
  • Y. Lebenthal
  • L. de Vries
  • M. Phillip
Original Article

DOI: 10.1007/s00592-013-0510-x

Cite this article as:
Shalitin, S., Ben-Ari, T., Yackobovitch-Gavan, M. et al. Acta Diabetol (2014) 51: 247. doi:10.1007/s00592-013-0510-x

Abstract

The aim of this study is to assess the impact of the internet-based upload blood glucose monitoring and therapy management system (Carelink®) in patients with type 1 diabetes. Diabetic patients treated with pump infusion for ≥3 months were prospectively randomized to use the CareLink® with (4 months) and without (4 months) diabetes-team initiated contact (n = 36, intervention group) or to continue standard care for 4 months and then transfer to the CareLink® without diabetes-team initiated contact (n = 34, control group). In the first 4 months, treatment was adjusted monthly by the same team in both groups. Main outcome measures were HbA1c level and scores on the Diabetes Treatment Satisfaction and Diabetes Quality of Life Questionnaires. Patients who submitted <3 times during each 4-month segment were considered noncompliant. Mean patient age was 14.02 ± 5.33 years; mean diabetes duration, 6.4 ± 4.7 years; median duration of pump treatment, 2.5 years. After 4 months, mean HbA1c level decreased from 8.75 ± 0.84 to 8.45 ± 0.90 % in the intervention group (p = 0.013) and from 8.65 ± 0.57 to 8.37 ± 0.73 % in the control group (p = 0.054). Within the intervention group, the difference in the change in HbA1c levels between compliant and noncompliant patients was significant (8.17 ± 0.81 vs. 8.99 ± 0.85 %, p = 0.017). Only in the compliant subgroup was the decrease from baseline significant (p = 0.006). Similar findings were noted in the control group at 8 months (p < 0.05 and p = 0.018, respectively). There were no significant changes in questionnaire scores at 4 or 8 months in either group. Use of the CareLink® system is associated with significantly improved glycemic control in compliant patients, with no apparent effect on patient satisfaction or quality of life.

Keywords

Web-based therapy Metabolic control Type 1 diabetes 

Abbreviations

CSII

Continuous subcutaneous insulin infusion

DKA

Diabetic ketoacidosis

DQOL

Diabetes Quality of Life Questionnaire

DTSQ

Diabetes Treatment Satisfaction Questionnaire

ISPAD

International Society for Pediatric and Adolescent Diabetes

SBGM

Self-blood glucose measurements

Copyright information

© Springer-Verlag Italia 2013

Authors and Affiliations

  • S. Shalitin
    • 1
    • 2
  • T. Ben-Ari
    • 1
  • M. Yackobovitch-Gavan
    • 1
    • 2
  • A. Tenenbaum
    • 1
  • Y. Lebenthal
    • 1
  • L. de Vries
    • 1
    • 2
  • M. Phillip
    • 1
    • 2
  1. 1.The Jesse Z. and Sara Lea Shafer Institute of Endocrinology and Diabetes, National Center for Childhood DiabetesSchneider Children’s Medical Center of IsraelPetach TikvaIsrael
  2. 2.Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael

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