Telemedical support to improve glycemic control in adolescents with type 1 diabetes mellitus
Telemedical support to improve glycemic control in adolescents with type 1 diabetes mellitus
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DOI：
10.1007/s00431-006-0156-6
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发表时间：
2006-10-01
影响因子：
3.6
通讯作者：
Schober, Edith
中科院分区：
文献类型：
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作者：
Rami, Birgit;Popow, Christian;Schober, Edith
前言：在这篇文章中，我们评估了远程医疗(TM)支持计划的可行性及其对青少年1型糖尿病(T1 DM)患者血糖控制的影响。36名青少年(m=20，研究开始时的中位年龄：15.3岁(10.7-19.3岁)，确诊时的中位年龄：9.3岁(2.1-13.8岁)，中位病程：6.4年(1.0-12.8岁)，糖化血红蛋白和糖化血红蛋白8%，全部接受强化胰岛素治疗)在6个月的交叉试验中(TM治疗3个月，常规支持和纸质日记治疗3个月)随机进行。在TM阶段，患者至少每天通过手机将他们的数据(日期、时间、血糖、碳水化合物摄入量、胰岛素剂量)发送到我们的服务器，而糖尿病医生每周通过短信服务(SMS)发回他们的建议。结果：TM期血糖控制改善，PD期血糖控制恶化：TM-PD组HbA1c(%，中位数(范围))：9.05(8-11.3)(0个月)，8.9(6.9-11.3)(3个月)，9.2(7.4-12.6)(6个月)，PD-TM组：8.9(8.3-11.6)，9.9(8.1-11)，和8.85(7.3-11.7)(p<；0.05)。患者认为TM支持计划是一个好主意。通用分组无线业务(GPRS)数据传输的技术问题导致数据丢失并降低患者满意度。结论：我们的远程医疗支持计划VIE-Diab在青少年中被证明是可行的，并有助于改善血糖控制。
Introduction: In this paper, we evaluated the feasibility of a telemedical (TM) support program and its effect on glycemic control in adolescents with type 1 diabetes mellitus (T1DM). Thirty-six adolescents (m=20, median age at the start of the study: 15.3 years (range: 10.7-19.3 years), median age at diagnosis: 9.3 years (2.1-13.8 years), median duration of disease: 6.4 years (1.0-12.8 years), HbA1c > 8%, all on intensified insulin therapy) were randomized in a crossover trial over 6 months (3 months with TM, 3 months with conventional support and paper diary (PD)). During the TM phase, the patients sent their data (date, time, blood glucose, carbohydrate intake, insulin dosage) via mobile phone, at least daily, to our server and diabetologists sent back their advice via short message service (SMS) once a week. Results: Glycemic control improved during the TM phase, while it deteriorated during the PD phase: TM-PD group HbA1c (%, median (range)): 9.05 (8-11.3) (at 0 months), 8.9 (6.9-11.3) (at 3 months), and 9.2 (7.4-12.6) (at 6 months), and PD-TM group: 8.9 (8.3-11.6), 9.9 (8.1-11), and 8.85 (7.3-11.7) (p < 0.05). Patients rated the TM support program to be a good idea. Technical problems with General Packet Radio Service (GPRS) data transmission led to data loss and decreased patient satisfaction. Conclusion: Our telemedical support program, VIE-DIAB, proved to be feasible in adolescents and helped to improve glycemic control.