title: The effectiveness of Internet-based blood glucose monitoring system on improving diabetes control in adolescents with type 1 diabetes.
abstract: OBJECTIVE
  To determine whether the use of an Internet-based blood glucose monitoring system could improve glycemic control in adolescents with type 1 diabetes mellitus (T1DM).
  
  
  METHODS
  In a randomized, controlled clinical trial, a total of 70 adolescent subjects with T1DM were recruited. Subjects randomized to the intervention group (n = 36) were instructed to submit their blood glucose levels weekly by Internet to the diabetes care team during a period of 6 months. Subjects randomized to the control group (n = 34) did not submit results but were under routine follow-up.
  
  
  RESULTS
  At baseline, patients were 15.1 ± 2.6 years of age with mean HbA1c of 8.3 ± 1.3%. At the 6-month follow-up period, no by-group differences in change from baseline to end of treatment HbA1c levels were detected. In the intervention group, 12/36 did not submit blood glucose levels and were classified as non-compliant. In a secondary exploratory analysis in which non-compliant patients were omitted, HbA1c values in the compliant intervention group declined from 8.5 ± 1.7% at baseline to 8.2 ± 1.2% at 6 months, while in the control group HbA1c values increased from 8.2 ± 1.1 to 8.4 ± 1.1%, this difference did not reach statistical significance.
  
  
  CONCLUSIONS
  An Internet-based blood glucose monitoring system was not associated with improved glycemic control in adolescents with T1DM. Identification of a sub-group of compliant subjects who may improve metabolic control by using this tool is needed.
authors.affiliation: Maccabi National Juvenile Diabetes Center, Raanana, Israel Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. landau.zohar@gmail.com
authors.forename: Zohar
authors.initials: Z
authors.lastname: Landau
authors.forename: Kineret
authors.initials: K
authors.lastname: Mazor-Aronovitch
authors.forename: Mona
authors.initials: M
authors.lastname: Boaz
authors.forename: Moran
authors.initials: M
authors.lastname: Blaychfeld-Magnazi
authors.forename: Chana
authors.initials: C
authors.lastname: Graph-Barel
authors.forename: Noa
authors.initials: N
authors.lastname: Levek-Motola
authors.forename: Orit
authors.initials: O
authors.lastname: Pinhas-Hamiel
mesh_terms: D000293:Adolescent; D015190:Blood Glucose Self-Monitoring / Q000295:instrumentation / Q000379:methods*; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D007332:Insulin Infusion Systems; D020407:Internet; D008297:Male; D010349:Patient Compliance; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin; D007328:Insulin; C517652:hemoglobin A1c protein, human