One-year efficacy and safety of Web-based follow-up using cellular phone in type 1 diabetic patients under insulin pump therapy: the PumpNet study.
OBJECTIVE
Conventional follow-up of type 1 diabetic patients treated with continuous subcutaneous insulin infusion (CSII) was compared with intensive coaching using the Web and the cellular phone network for retrospective data transmission and short message service (SMS).


METHODS
Thirty poorly controlled patients (HbA1c 7.5-10%) were enrolled in a bicenter, open-label, randomized, 12-month, two-period, crossover study. After a 1-month run-in period, 15 patients were randomly assigned to receive weekly medical support through SMS based upon weekly review of glucose values, while 15 patients continued to download self-monitored blood glucose (SMBG) values on a weekly basis without receiving SMS. After 6 months, patients crossed over to the alternate sequence for 6 additional months. Visits at the clinic were maintained every 3 months.


RESULTS
Patients with long-standing inadequately controlled diabetes (24 +/- 13 years) were included. A non-significant trend to reduction in HbA(1c) (-0.25+/-0.94%, P<0.10) and mean glucose values (-9.2+/-25 mg/dl, P=0.06) during the 6-month SMS sequence was observed as compared with the no-SMS period. No safety issue (hypoglycemia, glucose variability) was reported. Adherence to SMBG was not affected by the trial. Quality of life analysis suggests a significant improvement in DQOL global score, as well as the DQOL satisfaction with life subscale, during the SMS sequence.


CONCLUSIONS
Long-term telemedical follow-up of insulin pump-treated patients using a cellular phone-, SMS- and Web-based platform is feasible, safe, does not alter quality of life and associated with a trend toward improved metabolic control.
Benhamou
P-Y
PY
Department of Endocrinology, Grenoble University Hospital, BP 217 X, 38043 Grenoble cedex 09, France. pierre-yves.benhamou@wanadoo.fr
Melki
V
V
Boizel
R
R
Perreal
F
F
Quesada
J-L
JL
Bessieres-Lacombe
S
S
Bosson
J-L
JL
Halimi
S
S
Hanaire
H
H
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D002196:Capillaries; D040421:Cell Phone / Q000592:standards*; D018592:Cross-Over Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007003:Hypoglycemia / Q000453:epidemiology; D007332:Insulin Infusion Systems / Q000009:adverse effects; D020407:Internet; D018579:Patient Selection; D011788:Quality of Life; D012449:Safety; D011795:Surveys and Questionnaires
D001786:Blood Glucose; D006442:Glycated Hemoglobin