title: The effectiveness of Internet intervention on 926 patients with diabetes mellitus for up to 30 months.
abstract: OBJECTIVE
  To assess the long-term effect of an Internet blood glucose monitoring system (IBGMS) on patients with type 1 diabetes mellitus and patients with type 2 diabetes.
  
  
  METHODS
  In all, 1200 patients were offered to be taught to communicate with their endocrinologists using standardized glucose level reports by e-mail, and received feedback within 24 hours. The first 926 patients enrolled were reviewed consecutively from March 2011 to October 2013. Seventy-seven of these patients were excluded owing to lack of glycated hemoglobin (A1C) data. The remaining 849 patients consisted of 295 patients with type 1 diabetes and 554 patients with type 2 diabetes. Nonreporters are patients with no record of reporting (n=167), whereas the reporters had reported at least once (n=682). The A1C values were obtained at registration; follow-up values at 3-month intervals were recommended.
  
  
  RESULTS
  Reporter A1C decreased from 8.13%±1.34% to 7.74%±1.11% (p<0.0001). Reporters with type 1 diabetes dropped from 8.04%±1.23% to 7.72%±1.03% (n=238; p<0.0001). Reporters with type 2 diabetes dropped from 8.18%±1.40% to 7.75%±1.14% (n=444; p<0.0001) and were subdivided based on treatment: those on oral hypoglycemic agents declined from 7.96%±1.38% to 7.49%%±1.03% (p<0.0001), and those on insulin with or without oral hypoglycemic agents declined from 8.40%%±1.39% to 8.02%±1.20% (p<0.0001). The nonreporters did not show a significant change in A1C.
  
  
  CONCLUSIONS
  Initial and prolonged improvement was found in A1C levels for all reporters. The data support that numerous patients can be followed up effectively using the Internet for as long as 30 months.
authors.affiliation: Department of Endocrinology and Metabolism, St. Paul's Hospital, Vancouver, British Columbia, Canada; University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: hdtildesley@gmail.com.
authors.forename: Hugh D
authors.initials: HD
authors.lastname: Tildesley
authors.affiliation: McMaster University, Hamilton, Ontario, Canada.
authors.forename: Mary Ellen
authors.initials: ME
authors.lastname: Conway
authors.affiliation: McGill University, Montreal, Quebec, Canada.
authors.forename: Lan
authors.initials: L
authors.lastname: Deng
authors.affiliation: University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Augustine M
authors.initials: AM
authors.lastname: Lee
authors.affiliation: Vanderbilt University, School of Medicine, Nashville, Tennessee, USA.
authors.forename: Jeremy H M
authors.initials: JH
authors.lastname: Chan
authors.affiliation: Saint George's University, Grenada, West Indies.
authors.forename: Adel B
authors.initials: AB
authors.lastname: Mazanderani
authors.affiliation: Dartmouth College, Hanover, New Hampshire, USA.
authors.forename: Hamish G
authors.initials: HG
authors.lastname: Tildesley
authors.affiliation: Department of Endocrinology and Metabolism, St. Paul's Hospital, Vancouver, British Columbia, Canada; University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Adam S
authors.initials: AS
authors.lastname: White
authors.affiliation: University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Monika
authors.initials: M
authors.lastname: Pawlowska
authors.affiliation: University of Calgary, Calgary, Alberta, Canada.
authors.forename: Stuart A
authors.initials: SA
authors.lastname: Ross
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D015190:Blood Glucose Self-Monitoring / Q000379:methods*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000188:drug therapy*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000188:drug therapy*; D019468:Disease Management; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D020407:Internet; D008297:Male; D008875:Middle Aged; D012648:Self Care; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin
keywords: IBGMS; Internet blood glucose monitoring system; Internet intervention; SSGI; glycemia control; intervention par internet; online diabetes management; prise en charge en ligne du diabète; régulation de la glycémie; système de surveillance de la glycémie par internet