Telemedicine: Current status and prospects in type 2 diabetes

Abstract

Summary There has been rapid growth in studies involving TM in diabetes treatment in recent years. In France, while TM has proven its efficacy in DT1, there have been relatively few trials in T2D. Nevertheless, certain studies in the US have already shown benefits in terms of metabolic parameters compared with especially conventional treatment, which, in view of the high number of patients in a position to derive benefit, opens up broad new vistas. However, TM will only spread successfully on a national level through the concerted efforts of the various actors involved in its implementation. As regards the authorities, while a desire has been expressed to deploy TM nationally in five designated priority areas, its widespread use in diabetes therapy will depend upon the level of reimbursement agreed by the Health Insurance Department, and upon the costs to patients, but also on the perceived value of telephone consultations in terms of activity charges for hospitals and within the ambit of private practice. As regards health establishments, the spread of TM requires some reorganisation of healthcare, calling for intervention by paramedical staff acting by medical delegation in a context of inter-professional cooperation protocols. Such spread will thus depend upon the ability of firms developing medical devices to ensure compatibility of the information systems used. However, truly effective, implementation will depend first and foremost upon users themselves, in other words patients and healthcare teams, which means that each and every person must overcome their own resistance to change, to integrating TM devices and to making TM part of their daily lives as an effective instrument with which to optimise healthcare.