Mobile telemonitoring for achieving tighter targets of blood pressure control in patients with complicated diabetes: a pilot study.
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.
Earle
Kenneth A
KA
Thomas Addison Unit, St. George's Hospital NHS Trust, London, United Kingdom. k.earle@sgul.ac.uk
Istepanian
Robert S H
RS
Zitouni
Karima
K
Sungoor
Ala
A
Tang
Bee
B
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
D001786:Blood Glucose