title: An automated telemedicine system improves patient-reported well-being.
abstract: BACKGROUND
  Control of serum glucose levels is essential for the reduction of complications of diabetes. Telemedicine is one strategy through which serum glucose control can be improved.
  
  
  METHODS
  A total of 35 adult, insulin-treated patients with diabetes (type 1 and type 2) were enrolled in the present study (63.0 +/- 10 years of age, 63% female) and randomized to telemedicine monitoring (including cordless, remote glucose monitor, and transmitter, n = 17), or conventional follow-up (n = 18). Metabolic parameters were evaluated, and a quality of life questionnaire was administered both pre- and post-treatment.
  
  
  RESULTS
  Groups were similar at baseline in terms of demographic, quality of life, and metabolic parameters. Significant differences in post-treatment metabolic parameters were not observed, although serum glucose was marginally elevated in the control group compared to the telemedicine group (214 +/- 65 mg/dL vs. 171 +/- 77 mg/dL, P = 0.09). On the other hand, being clinically symptom-free (71% vs. 11%, P = 0.003), having no hypoglycemic events (82% vs. 17%, P = 0.0001), and having no hyperglycemic events (65% vs. 17%, P = 0.004) were all significantly more frequently reported in the telemedicine group compared to the control group. Compared to the control group, the telemedicine group reported experiencing significantly less anxiety, treatment difficulty, depression, disease-associated life complications, and feelings of impotence or ineptitude and significantly greater improvement in personal control over glucose, weight, and overall diabetes.
  
  
  CONCLUSIONS
  Though post-treatment metabolic differences were not observed between treatment groups, the telemedicine group reported significantly greater post-treatment experiences of improved quality of life and sense of control over the disease. Thus patient satisfaction can be enhanced through the use of telemedicine.
authors.affiliation: Epidemiology and Research Unit, E. Wolfson Medical Center, Holon, Israel; Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel. mboaz@wolfson.health.gov.il
authors.forename: Mona
authors.initials: M
authors.lastname: Boaz
authors.forename: Katerina
authors.initials: K
authors.lastname: Hellman
authors.forename: Julio
authors.initials: J
authors.lastname: Wainstein
mesh_terms: D000368:Aged; D001331:Automation; D001786:Blood Glucose / Q000378:metabolism*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000188:drug therapy; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007003:Hypoglycemia / Q000453:epidemiology; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D011788:Quality of Life; D012927:Social Control, Informal; D011795:Surveys and Questionnaires; D017216:Telemedicine
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin