title: [Effectiveness and economic impact of a program of integrated care with telemedicine support on insulin-treated type 2 diabetic patients (Study GITDIABE)].
abstract: OBJECTIVE
  To evaluate if insulin-treated type 2 diabetic patients with blood glucose self-monitoring (DIA), included in a program of integrated management of diabetes mellitus (DM), achieve a better level of metabolic control with telemedicine support than with conventional support, after 12 months follow-up. The impact on the use and cost of healthcare services, pharmaceutical expenditure, and consumption of test strips for blood glucose, was also assessed.
  
  
  METHODS
  A prospective parallel cohorts study.
  Four basic health areas of an integrated healthcare organisation.
  
  
  METHODS
  The study included 126 DIA patients aged 15 or more years, treated with rapid or intermediate Insulin and blood glucose self-monitoring, grouped into 42 cases and 84 controls, matched according to age, sex, level of metabolic control, and morbidity profile.
  
  
  METHODS
  Telematics physician-patient communication and download of blood glucose self-monitoring data through the Emminens eConecta®platform; test strips home delivered according to consumption. Hidden controls with usual follow-up.
  
  
  METHODS
  Glycosylated haemoglobin (%HbA1c); perception of quality of life (EuroQol-5 and EsDQOL); cardiovascular risk; use of healthcare resources; consumption of test strips; pharmaceutical and healthcare expenditure.
  
  
  RESULTS
  Reduction of 0.38% in HbA1c in the cases (95% CI:-0.89% to 0.12%). No significant differences with regard to any of the activities registered, or any significant change in the quality of life.
  
  
  CONCLUSIONS
  The results obtained are similar to other equivalent studies. The profile of the patient is elderly and with multiple morbidities, who still have technological limitations. To surpass these barriers, it would be necessary to devote more time to the training and to the resolution of possible technological problems.
authors.affiliation: Hospital de Palamós, Serveis de Salut Integrats Baix Empordà (SSIBE), Palamós, Girona, España; Grup de Recerca en Serveis Sanitaris i Resultats en Salut (GRESSIRES). Electronic address: jminoriza@ssibe.cat.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Inoriza
authors.affiliation: ABS Torroella de Montgrí, Serveis de Salut Integrats Baix Empordà (SSIBE), Torroella de Montgrí, Girona, España.
authors.forename: Annabel
authors.initials: A
authors.lastname: Ibañez
authors.affiliation: Hospital de Palamós, Serveis de Salut Integrats Baix Empordà (SSIBE), Palamós, Girona, España.
authors.forename: Xavier
authors.initials: X
authors.lastname: Pérez-Berruezo
authors.affiliation: Grado en Medicina UPF-UAB, Universitat Pompeu Fabra, Barcelona, España.
authors.forename: Cristina
authors.initials: C
authors.lastname: Inoriza-Nadal
authors.affiliation: Hospital de Palamós, Serveis de Salut Integrats Baix Empordà (SSIBE), Palamós, Girona, España; Grup de Recerca en Serveis Sanitaris i Resultats en Salut (GRESSIRES).
authors.forename: Jordi
authors.initials: J
authors.lastname: Coderch
mesh_terms: D000293:Adolescent; D000328:Adult; D015190:Blood Glucose Self-Monitoring / Q000191:economics; D016022:Case-Control Studies; D019033:Delivery of Health Care, Integrated / Q000191:economics*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy* / Q000191:economics*; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007328:Insulin / Q000191:economics* / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017216:Telemedicine / Q000191:economics*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007328:Insulin
keywords: Automonitorización de la glucosa sanguínea; Blood glucose self-monitoring; Calidad de vida; Diabetes mellitus; Quality of life; Telemedicina; Telemedicine