Telecare for teenagers with type 1 diabetes : a trial

Aim. The aim of this paper was to test in teenagers with type 1 diabetes mellitus (T1DM) the Glucobeeb (Gb), a web based tool to support the diabetes care. Methods. Gb transfers glucometer's data by phone and Internet to the PC of practitioner in files dedicated to each patient; the response returns to patient as 1-min vocal message. From outpatients paediatric clinic 28 teenagers (mean 14.8 years, range 10-20, male 14) with T1DM on multiple daily injections insulin therapy, with glicated haemoglobin (HbA1c) over 7% and >2 years' duration of the disease (9.1 years, range 2-15), were consequently randomized to telecare (glucometer transmission with feedback, group A) or control (standard communication by phone and face-to-face visits, group B). Glycaemia was tested four times per day and data transmitted every 2 weeks; clinician feedback returned within the following week. Two controls were excluded after randomization. Outcomes of 14 patients of A were compared with 12 of B. Results. In intervention group average HbA1c% decreased from baseline at 3 and 6 months in comparison with controls (9.5, 9.0, 9.1, vs 9.1, 9.4, 9.4 respectively). Controls after 6 months were introduced to Gb, and similar trend of HbAlc was observed in the following examinations at 3 and 6 month (9.4, 8.9, 8.7). Then, in both groups HbA1c after 12 months of Gb increased, and after 18 reduced (A: 9.2, and 8.8, B 9.1 and 8.5 respectively). The enhancement of HbA1c from baseline to end was significant (P=0.01). Conclusion. The tool improves metabolic control in teenagers with T1DM.