Long-term effect of the Internet-based glucose monitoring system on HbA1c reduction and glucose stability: a 30-month follow-up study for diabetes management with a ubiquitous medical care system.
OBJECTIVE
To investigate the long-term effectiveness of the Internet-based glucose monitoring system (IBGMS) on glucose control in patients with type 2 diabetes.


METHODS
We conducted a prospective, randomized, controlled trial in 80 patients with type 2 diabetes for 30 months. The intervention group was treated with the IBGMS, while the control group made conventional office visits only. HbA1c (A1C) was performed at 3-month intervals. For measuring of the stability of glucose control, the SD value of A1C levels for each subject was used as the A1C fluctuation index (HFI).


RESULTS
The mean A1C and HFI were significantly lower in the intervention group (n = 40) than in the control group (n = 40). (A1C [mean +/- SD] 6.9 +/- 0.9 vs. 7.5 +/- 1.0%, P = 0.009; HFI 0.47 +/- 0.23 vs. 0.78 +/- 0.51, P = 0.001; intervention versus control groups, respectively). Patients in the intervention group with a basal A1C >or=7% (n = 27) had markedly lower A1C levels than corresponding patients in the control group during the first 3 months and maintained more stable levels throughout the study (P = 0.022). Control patients with a basal A1C <7% (n = 15) showed the characteristic bimodal distribution of A1C levels, whereas the A1C levels in the intervention group remained stable throughout the study with low HFI.


CONCLUSIONS
Long-term use of the IBGMS has proven to be superior to conventional diabetes care systems based on office visits for controlling blood glucose and achieving glucose stability.
Cho
Jae-Hyoung
JH
Department of Endocrinology and Metabolism, The Catholic University of Korea, Seoul, Korea.
Chang
Sang-Ah
SA
Kwon
Hyuk-Sang
HS
Choi
Yoon-Hee
YH
Ko
Seung-Hyun
SH
Moon
Sung-Dae
SD
Yoo
Soon-Jib
SJ
Song
Ki-Ho
KH
Son
Hyun-Shik
HS
Kim
Hee-Seung
HS
Lee
Won-Chul
WC
Cha
Bong-Yun
BY
Son
Ho-Young
HY
Yoon
Kun-Ho
KH
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D015190:Blood Glucose Self-Monitoring; D001794:Blood Pressure; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D020407:Internet; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012648:Self Care
D001786:Blood Glucose; D006442:Glycated Hemoglobin