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Telecare Improves Glycemic Control
posted 05/14/04
Telecare was associated with improving glycemic control in
patients with type 1 diabetes that was inadequately controlled with intensive
insulin treatment.
A group of investigators led by Dr Yogish Kudva of the Mayo Clinic in Rochester,
USA, conducted a randomized trial and meta-analysis to evaluate the impact of
telecare on glycemic control. Telecare involves modem transmission of glucometer
data with clinician feedback. A total of 31 patients with type 1 diabetes that
was inadequately controlled with intensive insulin treatment (HbA1c>7.8%) were
randomized to telecare or a control (glucometer transmission without feedback)
for 6 months. Randomized trials of telecare were identified in a systematic
review of the literature and data on change in HbA1c were pooled from these
studies for comparison.
The investigators found that the concentration of HbA1c after 6 months was
significantly lower in telecare patients than in control patients (7.8% versus
8.2%; p=0.03). The chance of achieving HbA1c<7% at 6 months was greater in
telecare patients (29% versus 7%) but not statistically significant. Nurses
spent an additional 50 minutes per patient on the telephone with telecare
patients than with control patients. The meta-analysis of 7 randomized trials
revealed that the difference in mean change in HbA1c from baseline between
telecare patients and control patients was 0.4%.
The investigators concluded that telecare was associated with a small effect on
glycemic control in patients with type 1 diabetes that was inadequately
controlled with intensive insulin treatment.
Source: Diabetes In Control.com: Diabetes Care 2004;27:1088-94.
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