Telecare in a structured therapeutic education programme addressed to patients with type 1 diabetes and poor metabolic control.
OBJECTIVE
To assess the effects of telecare on the results of intensive follow-up in T1D patients with poor metabolic control.


METHODS
After initial evaluation, 40 T1D were randomised to either a Telecare (TG) or Conventional Group (CG). Patients had an intensive 6-month follow-up and helped to make decisions concerning treatment self-management. The TG had 12 appointments: 9 telematic with the GlucoBeep system+3 ambulatory. The CG had 12 outpatient appointments. At 0, 6 (end of study) and 12 months, metabolic control, self-management and quality of life were evaluated. Cost analysis was made at study end.


RESULTS
Thirty patients completed the study (16 TG, 14 CG). Intention to treat analysis included 19 TG and 16 CG. Improvement in HbA(1c) was similar in both groups TG: 8.4+/-1.2%; 7.5+/-1.4%; 7.6+/-0.9%, p=0.008; CG: 8.9+/-1.3%; 7.7+/-0.9%; 7.6+/-0.7%, p=0.001; with a decrease in hypoglycaemic events and improvement in self-management and quality of life. Patient costs were lower in the TG versus CG in appointment length (0.25h versus 0.5h). However, 30% of the diabetes team and patient appointments were longer than expected due to technical difficulties: (0.25h versus 1h).


CONCLUSIONS
Intensive telematic follow-up achieves similar results to those of intensive face-to-face follow-up with lower patient costs. However, communication technology must be improved.
Jansà
M
M
Diabetes Unit, Hospital Clínic, Barcelona, Spain. mjansa@clinic.ub.es
Vidal
M
M
Viaplana
J
J
Levy
I
I
Conget
I
I
Gomis
R
R
Esmatjes
E
E
D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000534:rehabilitation*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D006801:Humans; D007003:Hypoglycemia / Q000453:epidemiology; D007328:Insulin / Q000009:adverse effects; D008297:Male; D010353:Patient Education as Topic; D011788:Quality of Life; D013030:Spain; D017216:Telemedicine
D007328:Insulin