Telemedicine had no convincing effect on quality of life , mortality or hypoglycemia .
INTERPRETATION : Compared with usual care , the addition of telemedicine , especially systems that allowed medication adjustments with or without text messaging or a Web portal , improved HbA1C but not other clinical ly relevant outcomes among patients with diabetes
BACKGROUND : Telemedicine , the use of telecommunications to deliver health services , expertise and information , is a promising but unproven tool for improving the quality of  diabetes care  .
We summarized the effectiveness of different methods of telemedicine for the management of diabetes compared with usual care .
Insulin dose titration system in diabetes patients using a short messaging service automatically produced by a knowledge matrix.
BACKGROUND We design ed a system for diabetes patients treated with glargine , a long-acting insulin  , to make an automatic adjustment of insulin dose based on glucose level data and to provide the patients with the needed insulin dose by using a short message service ( SMS ) . We also compared diabetes patients who used our system with patients who received the conventional titration scheme .  METHODS Included were 100 type 2 diabetes patients whose blood glucose was suboptimally controlled on their previous antidiabetes treatment . Each participant was assigned to either the intervention or control group , each with 50 patients , using adaptive r and omization . We applied our system to the intervention group for 12 weeks , whereas the control group received a conventional titration scheme , seeking a target fasting blood glucose of < 120 mg/dL. RESULTS The fasting and postpr and ial glucose levels of the intervention group declined earlier than those of the control group . Lastly , a greater ( P = 0.023 ) reduction in hemoglobin A(1C ) from baseline to the end point was observed in the intervention group ( from 9.8 + /- 1.3 % to 7.4 + /- 0.7 % ) than in the control group ( from 9.8 + /- 1.2 % to 7.8 + /- 0.8 % ) . The incidence of symptomatic , asymptomatic , and nocturnal hypoglycemia was similar in both groups . There was a small increase in body weight from baseline to the end point with both the intervention ( 2.4 + /- 3.0 kg ) and control ( 2.2 + /- 2.8 kg ) groups . CONCLUSIONS This study demonstrated that SMS based on our specialized Internet-supported system is an effective and safe approach to long-acting insulin dose adjustments in patients with type 2 diabetes
Telemedicine had no convincing effect on quality of life , mortality or hypoglycemia .
INTERPRETATION : Compared with usual care , the addition of telemedicine , especially systems that allowed medication adjustments with or without text messaging or a Web portal , improved HbA1C but not other clinical ly relevant outcomes among patients with diabetes
BACKGROUND : Telemedicine , the use of telecommunications to deliver health services , expertise and information , is a promising but unproven tool for improving the quality of  diabetes care  .
We summarized the effectiveness of different methods of telemedicine for the management of diabetes compared with usual care .