title: Telemedical support to improve glycemic control in adolescents with type 1 diabetes mellitus.
abstract: BACKGROUND
  In this paper, we evaluated the feasibility of a telemedical (TM) support program and its effect on glycemic control in adolescents with type 1 diabetes mellitus (T1DM). Thirty-six adolescents (m=20, median age at the start of the study: 15.3 years (range: 10.7-19.3 years), median age at diagnosis: 9.3 years (2.1-13.8 years), median duration of disease: 6.4 years (1.0-12.8 years), HbA1c>8%, all on intensified insulin therapy) were randomized in a crossover trial over 6 months (3 months with TM, 3 months with conventional support and paper diary (PD)). During the TM phase, the patients sent their data (date, time, blood glucose, carbohydrate intake, insulin dosage) via mobile phone, at least daily, to our server and diabetologists sent back their advice via short message service (SMS) once a week.
  
  
  RESULTS
  Glycemic control improved during the TM phase, while it deteriorated during the PD phase: TM-PD group HbA1c (%, median (range)): 9.05 (8-11.3) (at 0 months), 8.9 (6.9-11.3) (at 3 months), and 9.2 (7.4-12.6) (at 6 months), and PD-TM group: 8.9 (8.3-11.6), 9.9 (8.1-11), and 8.85 (7.3-11.7) (p<0.05). Patients rated the TM support program to be a good idea. Technical problems with General Packet Radio Service (GPRS) data transmission led to data loss and decreased patient satisfaction.
  
  
  CONCLUSIONS
  Our telemedical support program, VIE-DIAB, proved to be feasible in adolescents and helped to improve glycemic control.
authors: Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria. Birgit.Rami@meduniwien.ac.at
authors: Birgit
authors: B
authors: Rami
authors: Christian
authors: C
authors: Popow
authors: Werner
authors: W
authors: Horn
authors: Thomas
authors: T
authors: Waldhoer
authors: Edith
authors: E
authors: Schober