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Hormones

, Volume 14, Issue 4, pp 632–643 | Cite as

Impact and duration effect of telemonitoring on HbA1c, BMI and cost in insulin-treated Diabetes Mellitus patients with inadequate glycemic control: A randomized controlled study

  • Stelios Fountoulakis
  • Labrini Papanastasiou
  • Alexandros Gryparis
  • Athina Markou
  • George Piaditis
Research paper

Abstract

OBJECTIVE: To monitor and control the blood glucose levels in inefficiently insulin-treated patients with type 1 and 2 diabetes mellitus (DM) using a telemonitoring system and determine whether the improvement of HbA1c has a lasting effect following its discontinuation. DESIGN: Seventy inefficiently controlled insulin-treated DM patients using telemonitoring (telemonitoring group-TG) [HbA1c 9.9±2.3% (85±24.9mmol/mol)] and 35 age-, body mass index (BMI)- and Hba1c-matched insulin-treated patients receiving outpatient care (control group-CG) [HbA1c 9.7±2.1% (82±23.4mmol/mol)] were enrolled. Data of TG were transmitted from the glucose-meters to our computers via modem. Communication was achieved via e-mails and mobile phone text-messages through integrated software. HbA1c and BMI were evaluated at enrollment, 3 and 6 months, and 6 months after telemonitoring discontinuation. Frequency of hypo- and hyperglycemias and cost were also analyzed. RESULTS: Significant reduction in HbA1c was observed in TG both at 3 [7.1±1.0% (54±10.5mmol/mol) p<0.001] and 6 months [6.9±0.9% (52±9.5mmol/mol) p<0.001], compared to the CG group at the same timepoints. Significant reduction was also observed in the TG subgroups with HbA1c≥10% and 10>HbA1c≥7.5% at 3 and 6 months, compared to CG. No statistically significant differences in BMI were observed between TG and CG. Six months after telemonitoring discontinuation, HbA1c in TG was slightly increased [7.3±1.0% (56±10.4mol/mol)]. Attenuation was also observed in both TG subgroups. Compared to CG, the number of monthly hypo- and hyperglycemias was reduced in TG. The intervention had a financial benefit for patients living more than 100 km from the health care provider. CONCLUSIONS: Telemonitoring can result in reduction of HbA1c and frequency of hypo- and hyperglycemias. This beneficial effect is slightly attenuated 6 months after terminating telemonitoring.

Key words

BMI Cost Diabetes HbA1c Telemedicine Telemonitoring 

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Copyright information

© Hellenic Endocrine Society 2015

Authors and Affiliations

  • Stelios Fountoulakis
    • 1
  • Labrini Papanastasiou
    • 1
  • Alexandros Gryparis
    • 2
  • Athina Markou
    • 2
  • George Piaditis
    • 1
  1. 1.Department of Endocrinology and Diabetes CenterAthens General Hospital “G. Gennimatas”AthensGreece
  2. 2.Department of Hygiene, Epidemiology and Medical StatisticsNational and Kapodistrian University of Athens Medical SchoolAthensGreece

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