title: Effect of Carelink, an internet-based insulin pump monitoring system, on glycemic control in rural and urban children with type 1 diabetes mellitus.
abstract: OBJECTIVE
  To determine whether use of the internet-based insulin pump monitoring system, Carelink, improved glycemic control in rural and urban children treated with insulin pump therapy.
  
  
  METHODS
  We reviewed records of 94 children treated with insulin pump therapy between the years 2004 and 2007 and compared glycemic control, diabetes self-care measures, frequency of clinic visits, and geographic location associated with Carelink use.
  
  
  RESULTS
  Carelink users showed improvement in hemoglobin A1c (HbA1c) levels [8.0 +/- 0.1 (SE) vs. 7.7 +/- 0.1 (SE), p = 0.002]. Carelink users uploaded pump and glucometer data 2.2 +/- 1.8 (SD) times per month over 0.8 +/- 0.4 (SD) yr. Patients who had no access to carelink software and were followed in a conventional manner showed no change in HbA1c levels [8.0 +/- 0.2 (SE) vs. 8.1 +/- 0.2 (SE), p = 0.17] during the study period. Carelink non-users, defined as patients who had Carelink access but did not use it, had a higher HbA1c level at the start of the study and did not change over the study period [8.9 +/- 0.2 (SE) vs. 9.0 +/- 0.3 (SE), p = 0.82]. Rural Carelink users showed improvement in HbA1c levels following Carelink use [7.9 +/- 0.2 (SE) vs. 7.4 +/- 0.2 (SE), p = 0.001], yet had significantly fewer clinic visits per year compared with urban patients [2.8 +/- 0.2 (SE) vs. 3.5 +/- 0.1 (SE), p = 0.001].
  
  
  CONCLUSIONS
  Use of the Carelink system was associated with improved glycemic control in children with type 1 diabetes on insulin pump therapy.
authors.affiliation: University of New Mexico School of Medicine, Albuquerque, NM, USA.
authors.forename: Erin A
authors.initials: EA
authors.lastname: Corriveau
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Durso
authors.forename: Ellen D
authors.initials: ED
authors.lastname: Kaufman
authors.forename: Betty J
authors.initials: BJ
authors.lastname: Skipper
authors.forename: Louise A
authors.initials: LA
authors.lastname: Laskaratos
authors.forename: Kimberly B
authors.initials: KB
authors.lastname: Heintzman
mesh_terms: D000293:Adolescent; D000553:Ambulatory Care; D015190:Blood Glucose Self-Monitoring; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000188:drug therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007332:Insulin Infusion Systems; D020407:Internet; D008297:Male; D012424:Rural Population; D016896:Treatment Outcome; D014505:Urban Population
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents