Self-Management of Diabetes Mellitus with Remote Monitoring (original) (raw)
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Telemedicine for the Self-Management of Type 2 Diabetes: A Literature Review
2021
The COVID-19 pandemic is an obstacle that prevents people living with type 2 diabetes from visiting primary health services. Telemedicine is a virtual health service that helps caregivers and clients to meet virtually. Telemedicine is capable of assisting sufferers in the form of self-management. This study aims to determine the effect of telemedicine on self-management of type 2 diabetes patients. This study uses a literature review design. Primary studies to be included in this review were searched from Pubmed electronic database. The inclusion criteria of studies were: published in the last five years in English-language journals, used randomized control trial design, had population aged > 18 years with type-2 diabetes, and used telemedicine. The exclusion criterion was comparing two or more telemedicine applications. A total of 11 studies was included in the review. Seven out of eleven studies showed a significant reduction in HbA1c in the intervention group than the control ...
DIABETES MANAGEMENT IN HOME TELECARE
This paper discusses the use of the UNSW/MedCare home telecare systems as a diabetes management tool. The home telecare system (HTS) has demonstrated its performance in storing and measuring clinical data, scheduling actions, plotting graphs and creating reports to help the care team optimize the management of chronically ill patients . The existing home telecare systems has been upgraded and further programmed for the recording of blood glucose measurements (BGL), insulin injection doses, hypoglycemic episodes, dietary intake, and exercise activity. Furthermore, based on those data the system will estimate future blood glucose levels and provide recommendations on insulin doses to bring BGLs within recommended levels.
Telemedicine Improved Diabetic Management
Military Medicine, 2000
Effective control of diabetes is known to delay or prevent the end-organ complications of this disease. Can telemedicine improve a patient's ability to self-manage diabetes? Twenty-eight patients entered a study comparing home telemedicine consultation with standard outpatient care. A nurse case manager contacted the telemedicine group once a week under the direction of a primary care physician, who contacted the telemedicine group once a month. Laboratory studies and total body weight were measured at the beginning and at the end of the 3-month study. The hemoglobin Ale (HbA 1c) and total body weight improved significantly in the intervention (telemedicine) group, as shown by a 16% reduction in mean HbA 1C level (from 9.5 to 8.2%)and a 4%mean weight reduction (from 214.3 to 206.7 pounds). Based on our experience, we present a functionally based telemedicine classification system to improve the application of electronic medicine in future studies.
Benefit of Telemedicine for Patients With Diabetes Mellitus
The mean HbA1c difference between Sensor Augmented Pump (SAP) therapy and Multiple Daily Injections (MDI) is 0.3 to 0.6% in favour of SAP, but adolescents, although treated with SAP therapy, show a progressive temporary deterioration of glucose control. Telemedicine in Type 1 Diabetes is thought to facilitate diabetes management and to improve compliance to CSII/SAP treatment especially during adolescence. The aim of the present study was to observe the long term impact on glycometabolic controlled by Telemedicine systems (Telemedicine Group) compared with traditional follow-up (Control Group) in Type 1 diabetes SAP treated adolescents. The observed HbA1c decrease in the group followed with telemedicine was associated with a better compliance to therapy in terms of frequency of sensor use, number of SMBG tests and number of insulin boluses.
Management of Type 2 Diabetes Mellitus through Telemedicine
PLOS ONE, 2015
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).
Journal of Medical Internet Research, 2017
Background Diabetes self-management involves adherence to healthy daily habits typically involving blood glucose monitoring, medication, exercise, and diet. To support self-management, some providers have begun testing remote interventions for monitoring and assisting patients between clinic visits. Although some studies have shown success, there are barriers to widespread adoption. Objective The objective of our study was to identify and classify barriers to adoption of remote health for management of type 2 diabetes. Methods The following 6 electronic databases were searched for articles published from 2010 to 2015: MEDLINE (Ovid), Embase (Ovid), CINAHL, Cochrane Central, Northern Light Life Sciences Conference Abstracts, and Scopus (Elsevier). The search identified studies involving remote technologies for type 2 diabetes selfmanagement. Reviewers worked in teams of 2 to review and extract data from identified papers. Information collected included study characteristics, outcomes, dropout rates, technologies used, and barriers identified.
JBI evidence implementation, 2022
Assess effect of diabetes self-management education and support methods, providers, duration, and contact time on glycemic control in adults with type 2 diabetes. Method: We searched MEDLINE, CINAHL, EMBASE, ERIC, and PsycINFO to December 2013 for interventions which included elements to improve participants' knowledge, skills, and ability to perform self-management activities as well as informed decision-making around goal setting. Results: This review included 118 unique interventions, with 61.9% reporting significant changes in A1C. Overall mean reduction in A1C was 0.74 and 0.17 for intervention and control groups; an average absolute reduction in A1C of 0.57. A combination of group and individual engagement results in the largest decreases in A1C (0.88). Contact hours !10 were associated with a greater proportion of interventions with significant reduction in A1C (70.3%). In patients with persistently elevated glycemic values (A1C > 9), a greater proportion of studies reported statistically significant reduction in A1C (83.9%). Conclusions: This systematic review found robust data demonstrating that engagement in diabetes selfmanagement education results in a statistically significant decrease in A1C levels. Practice implications: The data suggest mode of delivery, hours of engagement, and baseline A1C can affect the likelihood of achieving statistically significant and clinically meaningful improvement in A1C.
Telemonitoring management systems for diabetes Chronic disease
The technology behind telemonitoring management systems for diabetes is rapidly changing to help the health care sector in many areas. Physicians and other health care providers, who were previously unable to find a complete solution, are now able to easily, efficiently, and cost effectively monitor and maintain the health of patients with diabetes. Physicians need a solution to monitor their patients' health at home on a daily basis; also, they need the system they can log into to check their patients' daily progress. Telemonitoring management systems for diabetes will monitor and give advice to patients on a daily basis by connecting to health care provider systems using electronic health records. The system will have a knowledge base that contains information, article, videos, and books to increase the patient knowledge in this field. Telemonitoring management systems will thus improve the quality of provided health services.
Trials, 2013
Background: Diabetes prevalence is increasing and current methods of management are unsustainable. Effective approaches to supporting self-management are required. The aim of this randomized controlled trial is to establish whether supported telemetric monitoring of glycemic control and blood pressure results in reductions in glycosylated hemoglobin (HbA1c; the primary outcome of a measure of long-term glycemic control) and secondary outcomes of blood pressure and weight among people with poorly controlled diabetes compared to a control group receiving usual care. Methods/Design: Design: multi-center, randomized controlled trial with embedded qualitative study. Setting: primary care in Lothian, Kent, Glasgow and Borders regions in the UK. Participants: people with type 2 diabetes and confirmed HbA1c >7.5% (58 mmol/mol). Intervention/comparison: randomization to intervention or control groups will be performed by the Edinburgh Clinical Trials Unit. Participants in the intervention group will be shown how to use blood glucose and blood pressure monitors and weighing scales which use Bluetooth wireless technology to transmit readings via modem to a remote server. These participants will be asked to provide at least twice weekly measurements of morning and evening blood glucose and weekly measurements of weight and blood pressure. Measurements will be checked at least weekly by practice nurses who will contact the patients to adjust therapy according to guidelines and reinforce lifestyle advice. Participants in the control group will receive usual care. All participants will receive an individual education session. Follow-up: measurements will be performed at practices 9 months after randomization by research nurses blinded to allocation. The primary outcome measure is HbA1c and secondary outcomes measure are daytime systolic and diastolic blood pressure, weight and cost per quality-adjusted life year. Analysis: intention-to-treat analyses will be performed. The sample size of 320 participants allows for 20% drop-out and has 80% power at 5% significance to detect a 0.5% absolute (6 mmol/mol) fall in HbA1c in the intervention group. The qualitative study will explore the experiences of patients and professionals using the intervention. Trial registration: Trial registration number ISRCTN71674628
2012
We evaluated a telemedicine system in patients with type 1 diabetes who had optimized treatment with an insulin pump and a real-time continuous glucose monitoring system. We conducted a prospective, one-year study of 15 subjects. Three medical visits took place: pre-baseline, baseline and at 6 months. Each month the subjects transmitted information from the glucose meter, glucose sensor and insulin pump. We adjusted the treatment and returned the information by email. We evaluated psychological and metabolic variables, including HbA 1c , hypoglycaemia, hyperglycaemia and glucose variability. At baseline the mean age of the subjects was 40 years and the mean duration of diabetes was 22 years. There was a significant reduction in HbA 1c (7.50 to 6.97%) at 6 months, a significant increase in the number of selfmonitoring blood glucose checks per day (5.2 to 6.2), and significant improvements in variability: MODD, mean of daily difference (67 to 53) and MAGE, mean amplitude of glycaemic excursions (136 to 102). There were significant improvements in quality of life (92 to 87), satisfaction with the treatment (34 to 32) and less fear of hypoglycaemia (36 to 32). Adult subjects with type 1 diabetes on treatment with a continuous insulin infusion system and a real time glucose sensor and who have acceptable metabolic control and optimized treatment can benefit from the addition of a telemetry system to their usual outpatient follow-up.