The review indicates that most telemedicine strategies can be useful , either as an adjunct or to replace usual care , leading to clinical ly meaningful reduction in HbA1c
The effects of telemedicine strategies on the management of diabetes is not clear .
This study aim ed to investigate the impact of different telemedicine strategies on glycaemic control management of type 2 diabetes patients .
Preventing glycaemic relapse in recently controlled type 2 diabetes patients: a randomised controlled trial
Aims /hypothesisAfter achieving glycaemic control , many type 2 diabetic patients relapse to clinical ly significant levels of hyperglycaemia . We sought to determine the optimal frequency of telephone contact by nurse practitioners that was necessary to prevent glycaemic relapse . Methods This parallel , r and omised controlled trial ran from June 2002 to February 2006 at an academic medical centre , study ing 164 type 2 diabetic patients who had recently achieved glycaemic control . Participants were r and omly assigned by sequential , concealed , computer-generated allocation to a 2 year maintenance strategy consisting of : ( 1 ) routine follow-up ( n = 54 ) ; ( 2 ) routine follow-up and quarterly telephone contact ( n = 55 ) ; or ( 3 ) routine follow-up and monthly telephone contact ( n = 55 ) . Blinding was not possible . The primary outcome was cumulative incidence of glycaemic relapse , defined as an increase in HbA1c of ≥1 % ; all participants were analysed . Cumulative incidence and prevalent proportions were compared . Weight change and hypoglycaemia were also assessed . Results All participants r and omised were included in the analyses . The study was completed by 90 % of participants and intervention fidelity was high . At 24 months , the cumulative incidence of relapse was 41 % . At 12 months , prevalent proportions of relapse were 20 % , 14 % and 15 % for control , quarterly contact and monthly contact , respectively . At 24 months , they were 25 % , 21 % and 29 % , respectively . There was no statistically significant difference in cumulative incidence or prevalent proportions of relapse among the study arms . Adverse events did not differ between study arms . Conclusions /interpretationThis first r and omised controlled trial to test an intervention to prevent glycaemic relapse found that regularly scheduled telephone contact by a nurse practitioner was no more effective than routine follow-up care in preventing glycaemic relapse . Trial registration : Clinical Trials.gov NCT00362193 Funding : The research was supported by the National Institute of Diabetes and Digestive and Kidney Disease R18 DK 062258 , P60 DK 020593 and K24 DK 077875 . M. M. Huizinga was supported by National Institute of Environmental Health Sciences 1 K12 ES 015855 and National Center for Research Re sources 5 K12 RR 023266
The review indicates that most telemedicine strategies can be useful , either as an adjunct or to replace usual care , leading to clinical ly meaningful reduction in HbA1c
The effects of telemedicine strategies on the management of diabetes is not clear .
This study aim ed to investigate the impact of different telemedicine strategies on glycaemic control management of type 2 diabetes patients .