title: Telemedicine-supported insulin optimisation in primary care.
abstract: We investigated the feasibility of a mobile-phone based system for patients with type 2 diabetes who had recently commenced insulin therapy but remained poorly controlled. The system was evaluated in a feasibility study in a general practice setting with 23 patients over six months. A total of 22 patients successfully completed the study and used the system for a mean of 217 days (range 162-376). Blood glucose control improved, as reflected by a mean decrease in HbA(1c) of 0.66% (P = 0.05), with the mean insulin dose increasing by 17 units (P = 0.006). Blood glucose monitoring compliance was high, with readings available for 6.2 days per week, although use of the mobile phone decreased during the study. On average, the mobile phone diary was used for 3.5 days per week. Insulin dose adjustments were made throughout the study by all patients, but not as frequently as would be expected for the degree of hyperglycaemia observed.
authors.affiliation: Institute of Biomedical Engineering, Old Road Campus Research Building, Roosevelt Drive, University of Oxford, Oxford OX3 7DQ, UK.
authors.forename: Mark E
authors.initials: ME
authors.lastname: Larsen
authors.forename: Jane
authors.initials: J
authors.lastname: Turner
authors.forename: Andrew
authors.initials: A
authors.lastname: Farmer
authors.forename: Andrew
authors.initials: A
authors.lastname: Neil
authors.forename: Lionel
authors.initials: L
authors.lastname: Tarassenko
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism; D015190:Blood Glucose Self-Monitoring; D040421:Cell Phone; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D005240:Feasibility Studies; D005260:Female; D058006:General Practice; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D017216:Telemedicine / Q000379:methods*
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin