title: Telephonic Consultation and follow-up in Diabetics: Impact on Metabolic Profile, Quality of Life, and Patient Compliance.
abstract: BACKGROUND
  Diabetes mellitus (DM), being a long-term condition, requires consistent blood glucose monitoring and adjustment of doses of the antidiabetic drugs and insulin. Telehealth is an emerging field that can have a positive impact on the management of this disease.
  
  
  OBJECTIVE
  The aim was to study the impact of the frequency of consultation and follow-up on telephone of diagnosed follow-up patients of DM on glycemic and metabolic profiles, the patients' compliance, and their quality of life (QoL), and to compare the effectiveness of different modes of follow-up.
  
  
  METHODS
  One hundred twenty patients were enrolled from the outpatient department (OPD) including both type 1 and type 2 DM patients who had already been diagnosed and were on treatment. They were randomly assigned to one of three groups, each consisting of 40 subjects, according to the mode of follow-up: A (rare, i.e., less frequent outpatient visits), B (moderate, i.e., more frequent outpatient visits), and C (frequent, i.e., more frequent outpatient visits with weekly telephonic consultation). Metabolic profiles and the QoL were monitored. The patients' compliance with and adherence to the treatment, and dietary and exercise advice were assessed.
  
  
  RESULTS
  The patients' compliance with and adherence to the treatment was higher in group C, followed by groups B and A. There was a net decrease in adverse events, with an increase in the frequency of follow-up. Changes in glycated hemoglobin (HbA1c) suggested a positive impact of weekly telephonic consultation. The lipid profile was also positively affected, with maximum improvement being in high-density lipoproteins (HDLs) and triglycerides. There was an improvement in the QoL domains pertaining to physical health and endurance in patients with higher frequency of follow-ups. There was no effect on emotional or mental health. There was an overall deterioration of the financial domain, being most marked in group B. The treatment satisfaction questionnaire showed better results in the telephone intervention group.
  
  
  CONCLUSIONS
  Telephonic consultation can be a useful measure to improve the follow-up and management of patients with DM.
authors.affiliation: Department of Medicine, Guru Gobind Singh Medical College and Hospital, Baba Farid University of Health Sciences, Faridkot, Punjab, India.
authors.forename: Rupinderjeet
authors.initials: R
authors.lastname: Kaur
authors.affiliation: Department of Medicine, Guru Gobind Singh Medical College and Hospital, Baba Farid University of Health Sciences, Faridkot, Punjab, India.
authors.forename: Krishan Singh
authors.initials: KS
authors.lastname: Kajal
authors.affiliation: Department of Pediatrics, Guru Gobind Singh Medical College and Hospital, Baba Farid University of Health Sciences, Faridkot, Punjab, India.
authors.forename: Amarpreet
authors.initials: A
authors.lastname: Kaur
authors.affiliation: Department of Radiology, Guru Gobind Singh Medical College and Hospital, Baba Farid University of Health Sciences, Faridkot, Punjab, India.
authors.forename: Paramdeep
authors.initials: P
authors.lastname: Singh
keywords: Compliance; Diabetes; Quality of life (QoL); Telehealth; Telephone