title: Management of Type 2 Diabetes Mellitus through Telemedicine.
abstract: BACKGROUND
  Type 2 diabetes mellitus T2DM has a huge and growing burden on public health, whereas new care models are not implemented into clinical practice; in fact the purpose of this study was to test the effectiveness of a program of integrated care for T2DM, compared with ordinary diligence.
  
  
  METHODS
  "Progetto Diabete Calabria" is a new organizational model for the management of patients with diabetes mellitus, based on General Practitioners (GPs) empowerment and the use of a web-based electronic health record, shared in remote consultations among GPs and Hospital Consultants. One-year change in glucose and main cardiovascular risk factors control in 104 patients (Cases) following this integrated care program has been evaluated and compared with that of 208 control patients (Controls) matched for age, gender, and cardiometabolic profile, and followed in an ordinary outpatient medical management by the Consultants only. Both patient groups had Day Hospitals before and after the study period.
  
  
  RESULTS
  The mean number of accesses to the Consultants during the study was 0.6 ± 0.9 for Cases, and 1.3 ± 1.5 for Controls (p<0.0001). At follow-up, glycated hemoglobin (HbA1c) significantly decreased from 58 ± 6 to 54 ± 8 mmol/mol in Cases only (p=0.01); LDL cholesterol decreased in both groups; body mass index decreased in Cases only, from 31.0 ± 4.8 to 30.5 ± 4.6 kg/m(2) (p=0.03).
  
  
  CONCLUSIONS
  The present study demonstrates that a health care program based on GPs empowerment and taking care plus remote consultation with Consultants is at least as effective as standard outpatient management, in order to improve the control of T2DM.
authors.affiliation: Metabolic Diseases Unit, Department of Clinical and Experimental Medicine, "Mater Domini" Hospital, "Magna Græcia" University, Catanzaro, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Carallo
authors.affiliation: Metabolic Diseases Unit, Department of Clinical and Experimental Medicine, "Mater Domini" Hospital, "Magna Græcia" University, Catanzaro, Italy.
authors.forename: Faustina Barbara
authors.initials: FB
authors.lastname: Scavelli
authors.affiliation: General Practitioners, National Health Service, Catanzaro, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Cipolla
authors.affiliation: Metabolic Diseases Unit, Department of Clinical and Experimental Medicine, "Mater Domini" Hospital, "Magna Græcia" University, Catanzaro, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Merante
authors.affiliation: Metabolic Diseases Unit, Department of Clinical and Experimental Medicine, "Mater Domini" Hospital, "Magna Græcia" University, Catanzaro, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Medaglia
authors.affiliation: Metabolic Diseases Unit, Department of Clinical and Experimental Medicine, "Mater Domini" Hospital, "Magna Græcia" University, Catanzaro, Italy.
authors.forename: Concetta
authors.initials: C
authors.lastname: Irace
authors.affiliation: Metabolic Diseases Unit, Department of Clinical and Experimental Medicine, "Mater Domini" Hospital, "Magna Græcia" University, Catanzaro, Italy.
authors.forename: Agostino
authors.initials: A
authors.lastname: Gnasso
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D016022:Case-Control Studies; D008078:Cholesterol, LDL / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism / Q000473:pathology / Q000517:prevention & control / Q000628:therapy*; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D058005:General Practitioners / Q000523:psychology; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D019114:Remote Consultation; D017216:Telemedicine
chemical_list: D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin