Abstract
To determine whether diabetes education can be provided as effectively through telemedicine technology as through in-person encounters with diabetes nurse and nutrition educators. A total of 56 adults with diabetes were randomized to receive diabetes education in person (control group) or via telemedicine (telemedicine group) and were followed prospectively. The education consisted of three consultative visits with diabetes nurse and nutrition educators. The in-person and telemedicine groups were compared using measures of glycemic control (HbA(1c)) and questionnaires to assess patient satisfaction and psychosocial functioning as related to diabetes. Outcome measures were obtained at baseline, immediately after the completion of diabetes education, and 3 months after the third educational visit. Patient satisfaction was high in the telemedicine group. Problem Areas in Diabetes scale scores improved significantly with diabetes education (adjusted P < 0.05, before vs. immediately after education and 3 months after education), and the attainment of behavior-change goals did not differ between groups. With diabetes education, HbA(1c) improved from 8.6 +/- 1.8% at baseline to 7.8 +/- 1.5% immediately after education and 7.8 +/- 1.8% 3 months after the third educational visit (unadjusted P < 0.001, P = 0.089 adjusted for BMI and age), with similar changes observed in the telemedicine and in-person groups. Diabetes education via telemedicine and in person was equally effective in improving glycemic control, and both methods were well accepted by patients. Reduced diabetes-related stress was observed in both groups. These data suggest that telemedicine can be successfully used to provide diabetes education to patients.
Highlights
To determine whether diabetes education can be provided as effectively through telemedicine technology as through in-person encounters with diabetes nurse and nutrition educators
Problem Areas in Diabetes scale scores improved significantly with diabetes education, and the attainment of behaviorchange goals did not differ between groups
HbA1c improved from 8.6 Ϯ 1.8% at baseline to 7.8 Ϯ 1.5% immediately after education and 7.8 Ϯ 1.8% 3 months after the third educational visit, with similar changes observed in the telemedicine and in-person groups
Summary
OBJECTIVE — To determine whether diabetes education can be provided as effectively through telemedicine technology as through in-person encounters with diabetes nurse and nutrition educators. HbA1c improved from 8.6 Ϯ 1.8% at baseline to 7.8 Ϯ 1.5% immediately after education and 7.8 Ϯ 1.8% 3 months after the third educational visit (unadjusted P Ͻ 0.001, P ϭ 0.089 adjusted for BMI and age), with similar changes observed in the telemedicine and in-person groups. CONCLUSIONS — Diabetes education via telemedicine and in person was effective in improving glycemic control, and both methods were well accepted by patients. Reduced diabetes-related stress was observed in both groups These data suggest that telemedicine can be successfully used to provide diabetes education to patients. We used a prospective randomized study to investigate the hypothesis that diabetes education can be provided as effectively through telemedicine technology as through in-person encounters with diabetes educators. Patients were excluded who had a history of not keeping doctor’s appointments, had profound visual or hearing impairment, had psychiatric illness not controlled with medications, had a history of illicit drug use or heavy alcohol consumption (more than four alcoholic drinks per day), and were not willing to travel to Syracuse if randomized to receive diabetes education in Izquierdo and Associates
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