title: Group diabetes education administered through telemedicine: tools used and lessons learned.
abstract: OBJECTIVE
  To describe the use of telemedicine for teaching group diabetes education classes to individuals with diabetes mellitus in a rural medically underserved area.
  
  
  METHODS
  Adults with diabetes from a rural area served by Oswego Hospital in upstate New York were asked to participate in this study. Volunteers received diabetes education through real-time teleconferencing (n=27) by joining age- and sex-matched patients from the Joslin Diabetes Center, Syracuse, NY, in our "Living with Diabetes Class" (n=39). The two 3-h sessions offered comprehensive diabetes education by a diabetes nurse educator, dietitian, and exercise physiologist. These sessions were followed in 3 months by a 3-h follow-up class. Each group receiving tele-education consisted of two or three patients with diabetes.
  
  
  RESULTS
  The hemoglobin A1c test (a blood test that estimates the overall average glucose levels over the past 3 months) improved in the face-to-face and the telemedicine groups. There was no significant change in weight between groups. Each group had significant improvements in scores on the Problem Areas In Diabetes survey, which is a measure of emotional functioning in diabetes. Diabetes treatment satisfaction as measured in the Diabetes Treatment Satisfaction Questionnaire improved in the face-to-face group but not in the telemedicine group. Although the face-to-face group had significantly higher scores in the Diabetes Treatment Satisfaction Questionnaire, the telemedicine group was highly satisfied with the services provided.
  
  
  CONCLUSIONS
  Telemedicine offers an effective alternative approach for providing group diabetes education to individuals with poor access to diabetes education programs.
authors.affiliation: Joslin Diabetes Center, SUNY Upstate Medical University, Syracuse, New York 13214, USA. Kearnsj@upstate.edu
authors.forename: JoAnn W
authors.initials: JW
authors.lastname: Kearns
authors.forename: Deborah
authors.initials: D
authors.lastname: Bowerman
authors.forename: Karen
authors.initials: K
authors.lastname: Kemmis
authors.forename: Roberto E
authors.initials: RE
authors.lastname: Izquierdo
authors.forename: Michael
authors.initials: M
authors.lastname: Wade
authors.forename: Ruth S
authors.initials: RS
authors.lastname: Weinstock
mesh_terms: D001835:Body Weight; D003920:Diabetes Mellitus / Q000628:therapy*; D004032:Diet; D015444:Exercise; D006442:Glycated Hemoglobin; D006293:Health Promotion / Q000379:methods; D006801:Humans; D007858:Learning; D008507:Medically Underserved Area; D009518:New York; D010353:Patient Education as Topic / Q000379:methods*; D017060:Patient Satisfaction; D019035:Rural Health Services / Q000458:organization & administration*; D013685:Telecommunications / Q000458:organization & administration; D017216:Telemedicine / Q000458:organization & administration*
chemical_list: D006442:Glycated Hemoglobin