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Telemedical support to improve glycemic control in adolescents with type 1 diabetes mellitus

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Abstract

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.

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Abbreviations

T1DM:

Type 1 diabetes mellitus

TM:

Telemedicine/telemedical

PD:

Paper diary

BMI:

Body mass index

DCCT:

The Diabetes Control and Complications Trial

SMS:

Short message service

GPRS:

General Packet Radio Service

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Acknowledgment

This project was, in part, sponsored by Telecom Austria.

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Authors and Affiliations

  1. Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria

    Birgit Rami & Edith Schober

  2. Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria

    Christian Popow

  3. Department of Medical Cybernetics and Artificial Intelligence, Medical University of Vienna, Vienna, Austria

    Werner Horn

  4. Austrian Research Institute for Artificial Intelligence (ÖFAI), Vienna, Austria

    Werner Horn

  5. Cancer Research Institute, Department of Epidemiology, Medical University of Vienna, Vienna, Austria

    Thomas Waldhoer

Authors
  1. Birgit Rami
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  2. Christian Popow
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  3. Werner Horn
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  4. Thomas Waldhoer
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  5. Edith Schober
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Corresponding author

Correspondence to Birgit Rami.

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Rami, B., Popow, C., Horn, W. et al. Telemedical support to improve glycemic control in adolescents with type 1 diabetes mellitus. Eur J Pediatr 165, 701–705 (2006). https://doi.org/10.1007/s00431-006-0156-6

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  • DOI: https://doi.org/10.1007/s00431-006-0156-6

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