title: An Internet-based health gateway device for interactive communication and automatic data uploading: Clinical efficacy for type 2 diabetes in a multi-centre trial.
abstract: Introduction The aim of this study was to improve the quality of diabetes control and evaluate the efficacy of an Internet-based integrated healthcare system for diabetes management and safety. Methods We conducted a large-scale, multi-centre, randomized clinical trial involving 484 patients. Patients in the intervention group ( n = 244) were treated with the Internet-based system for six months, while the control group ( n = 240) received the usual outpatient management over the same period. HbA1c, blood chemistries, anthropometric parameters, and adverse events were assessed at the beginning of the study, after three months, and the end of the study. Results There were no initial significant differences between the groups with respect to demographics and clinical parameters. Upon six-month follow-up, HbA1c levels were significantly decreased from 7.86 ± 0.69% to 7.55 ± 0.86% within the intervention group ( p < 0.001) compared to 7.81 ± 0.66% to 7.70 ± 0.88% within the control group. Postprandial glucose reduction was predominant. A subgroup with baseline HbA1c higher than 8% and good compliance achieved a reduction of HbA1c by 0.8 ± 1.05%. Glucose control and waist circumference reduction were more effective in females and subjects older than 40 years of age. There were no adverse events associated with the intervention. Discussion This e-healthcare system was effective for glucose control and body composition improvement without associated adverse events in a multi-centre trial. This system may be effective in improving diabetes control in the general population.
authors.affiliation: 1 Department of Internal Medicine, Division of Endocrinology and Metabolism, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Jae Hyoung
authors.initials: JH
authors.lastname: Cho
authors.affiliation: 1 Department of Internal Medicine, Division of Endocrinology and Metabolism, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Hun-Sung
authors.initials: HS
authors.lastname: Kim
authors.affiliation: 2 Department of Internal Medicine, Division of Endocrinology and Metabolism, Sungkyunkwan University, Seoul, Korea.
authors.forename: Seung Hyun
authors.initials: SH
authors.lastname: Yoo
authors.affiliation: 3 Department of Internal Medicine, Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Chang Hee
authors.initials: CH
authors.lastname: Jung
authors.affiliation: 3 Department of Internal Medicine, Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Woo Je
authors.initials: WJ
authors.lastname: Lee
authors.affiliation: 2 Department of Internal Medicine, Division of Endocrinology and Metabolism, Sungkyunkwan University, Seoul, Korea.
authors.forename: Cheol Young
authors.initials: CY
authors.lastname: Park
authors.affiliation: 1 Department of Internal Medicine, Division of Endocrinology and Metabolism, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Hae Kyung
authors.initials: HK
authors.lastname: Yang
authors.affiliation: 3 Department of Internal Medicine, Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Joong Yeol
authors.initials: JY
authors.lastname: Park
authors.affiliation: 2 Department of Internal Medicine, Division of Endocrinology and Metabolism, Sungkyunkwan University, Seoul, Korea.
authors.forename: Sung Woo
authors.initials: SW
authors.lastname: Park
authors.affiliation: 1 Department of Internal Medicine, Division of Endocrinology and Metabolism, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Kun Ho
authors.initials: KH
authors.lastname: Yoon
mesh_terms: D000368:Aged; D001774:Blood Chemical Analysis; D001837:Body Weights and Measures; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D017598:Efficiency, Organizational; D005260:Female; D006442:Glycated Hemoglobin; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data; D061214:Patient Safety; D000073278:Self-Management / Q000379:methods*; D017216:Telemedicine / Q000458:organization & administration*; D016896:Treatment Outcome
chemical_list: D006442:Glycated Hemoglobin
keywords: E-health; home telecare; online health