Impact of MyCareTeam for poorly controlled diabetes mellitus.
OBJECTIVE
Web-based diabetes management can be used to provide frequent interactions between patients and providers and thus result in improved glycemic control.


METHODS
In a single-center, prospective feasibility study, 16 poorly controlled patients with either type 1 or 2 diabetes mellitus were enrolled to assess the impact of using MyCareTeam, a web-based diabetes management application, for diabetes management. Patients were asked to transfer their blood glucose data electronically, maintain exercise logs, and communicate with their provider via MyCareTeam. The provider gave clinical interventions to optimize blood glucose control and provided feedback via MyCareTeam. Diabetes, nutrition, and exercise information was also available via MyCareTeam.


RESULTS
A significant reduction of over 2.22% points in hemoglobin A1C was seen for the total patient population. Differences between moderate/heavy users (n = 8) versus light/never users (n = 8) of MyCareTeam were evaluated for intergroup differences based upon utilization. Moderate/heavy users had a significant 6-month A1C reduction of 3.15 percentage points compared with a reduction of 1.28 percentage points in light/never users. Other secondary end points were improved as well, including systolic blood pressure, diastolic blood pressure, total cholesterol, high-density lipoprotein, low-density lipoprotein, and triglycerides. However, as expected, body mass index levels increased because of aggressive diabetes management with insulin therapy.


CONCLUSIONS
These results demonstrate a significant treatment effect from the MyCareTeam application. A larger randomized control trial is under way at the Boston Veterans Administration Healthcare System. If these results are confirmed as expected, then web-based diabetes management may prove to be the link to achieving target American Diabetes Association glycemic goals in patients with poorly controlled diabetes.
Smith
Karen E
KE
Medical Associates, Canton, Georgia, USA.
Levine
Betty A
BA
Clement
Stephen C
SC
Hu
Ming-Jye
MJ
Alaoui
Adil
A
Mun
Seong K
SK
D001786:Blood Glucose / Q000032:analysis*; D003194:Computer-Assisted Instruction / Q000295:instrumentation* / Q000379:methods; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D006801:Humans; D020407:Internet; D008422:Materials Testing; D018670:Monitoring, Ambulatory; D018579:Patient Selection; D011446:Prospective Studies; D012107:Research Design
D001786:Blood Glucose