Effects of telemedicine intervention on the management of diabetic complications in type 2 diabetes

Abstract

Some studies have shown that telemedicine is effective for managing serum glucose levels in patients with type 2 diabetes (T2DM), but few studies have examined the effect of telemedicine on the management of complications in T2DM. The aim of this study was to compare the effects of telemedicine with those of outpatient care on the following parameters in T2DM patients: hemoglobin Alc (HbA1c), urinary albumin to creatinine ratio (UACR), carotid plaque, and incidence of hypoglycemia. In total, 148 adult patients with T2DM were randomized into a telemedicine group (n = 74) and a control group (n = 74). In the telemedicine group, a wireless intelligent blood-glucose meter was used to monitor blood-glucose levels, transmit data, and upload information on diet, exercise frequency, and oral medications, while the control group underwent routine outpatient follow-up. HbA1c, UACR, incidence of hypoglycemia, and carotid plaque were measured at baseline and at 3 and 6 months in the telemedicine group and the control group. There were no statistically significant differences in baselines data (p > 0.05) between the telemedicine group and the control group such as age (50.04 ± 5.76 vs. 52.21 ± 8.38, p = 0.750), diabetes course (6.24 ± 1.95 vs. 6.09 ± 1.66, p = 0.622), and gender (51/21 vs. 43/27, p = 0.236). After 6 months of follow-up, the telemedicine group, compared with the control group, showed significant decreases in incidence of hypoglycemia (25% vs. 41.4%, p = 0.038) and HbA1c (7.38 ± 1.67% vs. 8.22 ± 2.04%, p 0.05) between the telemedicine group and the control group. The telemedicine system reduced rate of hypoglycemia and indexes of HbA1c in patients with T2DM, whereas no significant differences in UACRs or carotid plaque were found.