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

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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.

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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

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Acknowledgments

The authors wish to thank the study coordinators Alona Hamo, Ayelet Parnes, and Sofi Balisiano for their study assistance and Gloria Ginzach for editing the manuscript.

This study was funded by Medtronic World Trade Corporation, Israel.

Conflict of interest

None.

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Authors and Affiliations

  1. The Jesse Z. and Sara Lea Shafer Institute of Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children’s Medical Center of Israel, 14 Kaplan Street, 49202, Petach Tikva, Israel

    S. Shalitin, T. Ben-Ari, M. Yackobovitch-Gavan, A. Tenenbaum, Y. Lebenthal, L. de Vries & M. Phillip

  2. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    S. Shalitin, M. Yackobovitch-Gavan, L. de Vries & M. Phillip

Authors
  1. S. Shalitin
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  2. T. Ben-Ari
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  3. M. Yackobovitch-Gavan
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  4. A. Tenenbaum
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  5. Y. Lebenthal
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  6. L. de Vries
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  7. M. Phillip
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Corresponding author

Correspondence to S. Shalitin.

Additional information

Communicated by Antonio Secchi.

ClinicalTrials.gov number: NCT00814476.

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Shalitin, S., Ben-Ari, T., Yackobovitch-Gavan, M. et al. Using the Internet-based upload blood glucose monitoring and therapy management system in patients with type 1 diabetes. Acta Diabetol 51, 247–256 (2014). https://doi.org/10.1007/s00592-013-0510-x

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  • DOI: https://doi.org/10.1007/s00592-013-0510-x

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