title: Mobile telemonitoring for achieving tighter targets of blood pressure control in patients with complicated diabetes: a pilot study.
abstract: BACKGROUND
  Hypertension is a major risk factor for the long-term complications of diabetes. Mobile, self-measurement of blood pressure is emerging as a method to manage blood pressure in general, but its impact in patients with diabetes is unclear.
  
  
  METHODS
  We randomized 137 patients with diabetes and hypertension to either mobile telemonitoring (n = 72) or usual care (n = 65). Clinic blood pressure was recorded at baseline and after 6 months. Patients in the intervention arm transmitted weekly blood pressure readings wirelessly, using adapted sensors via mobile phones to a central server. Clinicians received the data in real-time and using a web-based application provided management advice to the patient and their physicians.
  
  
  RESULTS
  Systolic blood pressure fell significantly in the patients in the intervention group (mean [95% confidence interval], -6.5 [-0.8 to -12.2] mm Hg; P = 0.027) and remained unchanged in the control group (2.1 [9.3 to -5.0] mm Hg; P = 0.57). Patients within the intervention arm of African origin seemed to benefit more from the intervention. In addition, those who achieved a systolic blood pressure of <120 mm Hg had lower average blood sugars than those with higher readings (7.8 [SD 1.6] vs. 8.9 [SD 2.2] mmol/L; P = 0.02).
  
  
  CONCLUSIONS
  In patients with diabetes, mobile telemonitoring has potential for delivering intensified care to improve blood pressure control, and its use may be associated with reduced exposure to hyperglycemia.
authors.affiliation: Thomas Addison Unit, St. George's Hospital NHS Trust, London, United Kingdom. k.earle@sgul.ac.uk
authors.forename: Kenneth A
authors.initials: KA
authors.lastname: Earle
authors.forename: Robert S H
authors.initials: RS
authors.lastname: Istepanian
authors.forename: Karima
authors.initials: K
authors.lastname: Zitouni
authors.forename: Ala
authors.initials: A
authors.lastname: Sungoor
authors.forename: Bee
authors.initials: B
authors.lastname: Tang
mesh_terms: D001786:Blood Glucose / Q000032:analysis*; D001794:Blood Pressure / Q000502:physiology*; D048909:Diabetes Complications / Q000150:complications / Q000378:metabolism / Q000628:therapy*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D008875:Middle Aged; D010865:Pilot Projects; D018709:Statistics, Nonparametric; D013685:Telecommunications / Q000592:standards*; D006113:United Kingdom; D014505:Urban Population
chemical_list: D001786:Blood Glucose