Impact of modem-transferred blood glucose data on clinician work efficiency and patient glycemic control.
BACKGROUND
Communication of blood glucose (BG) results between patients and health care providers (HCPs) is of established benefit and remains a critical part of the diabetes management process. Currently, HCPs typically receive BG data from patients at the time of clinic visits or by telephone. The Accu-Chek Acculink modem (Roche Diagnostics Corp., Indianapolis, IN) provides an additional and attractive option that can potentially facilitate this communication.


METHODS
To assess the impact of modem transfer of BG, we studied 47 participants with diabetes enrolled in a diabetes education program. Subjects were randomized to weekly communication of BG data to their HCP by either telephone (n = 23) or modem (n = 24) for 4 weeks. Mean age (+/- SD) was 44 +/- 15 years, 62% were female, 74% used insulin, 53% had type 1 diabetes, and mean baseline glycosylated hemoglobin (A1C) was 8.8% (range 5.2-13.2%).


RESULTS
There were no differences between groups in the amount of time the HCP spent analyzing BG data and communicating with patients (12.6 +/- 6.1 min/week in the telephone group and 11.5 +/- 5.1 min/week in the modem group) or in the number of patient and HCP attempts needed to make contact. There were similar improvements in A1C between groups (change of -0.4 +/- 0.7% in the telephone group and -0.9 +/- 1.4% in the modem group, P = 0.18). BG data provided by telephone had a 6% error rate, in contrast to modem-sent data, which were transmitted without error.


CONCLUSIONS
Modem transfer of BG data can provide an accurate and clinically useful option for communication between patients and their HCP and has comparable effects on A1C.
Bergenstal
Richard M
RM
International Diabetes Center, Minneapolis, Minnesota 55416, USA.
Anderson
Robyn L
RL
Bina
Dawn M
DM
Johnson
Mary L
ML
Davidson
Janet L
JL
Solarz-Johnson
Brenda
B
Kendall
David M
DM
D000328:Adult; D001786:Blood Glucose / Q000032:analysis*; D015190:Blood Glucose Self-Monitoring / Q000706:statistics & numerical data; D003920:Diabetes Mellitus / Q000097:blood* / Q000628:therapy*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000628:therapy; D004526:Efficiency; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006266:Health Education; D006801:Humans; D008297:Male; D008875:Middle Aged; D003629:Modems; D008991:Monitoring, Physiologic; D009726:Nurses; D010820:Physicians; D015203:Reproducibility of Results; D017216:Telemedicine / Q000379:methods*
D001786:Blood Glucose; D006442:Glycated Hemoglobin