The Efficiency of Telemedicine to Optimize Metabolic Control in Patients With Diabetes in Turkey
Condition: Telemedicine; Telehealth
Study type: Interventional

Summary: 
      The direct and indirect costs of treating diabetes are high. 10-15% of the health budgets of
      many countries are spent on diabetes treatment. Most of these expenses are due to the
      treatment and follow-up costs of complications seen in patients who are not well monitored
      and whose metabolic control is not achieved. the rapid increase in diabetes causes polyclinic
      and hospital services to become more intense. Despite the increasing number of patients, both
      performance and due to non-physician occupational groups' insufficiency (Diabetes Dietician,
      Diabetes Nurse), patients can only be given an appointment once a year, and patients cannot
      be allocated sufficient time during the appointment. Since these problems are valid
      worldwide, Telemedicine programs are designed to provide easy, cheap, and practical follow-up
      and treatment of many chronic diseases in various states of the USA and many developed
      European countries.
    

Detailed description: 
      The project is designed as a randomized controlled trial with approximately 100 subjects
      receiving a telemedicine intervention and approximately 100 receiving usual care. Eligibility
      requires having diabetes and being a Medicare beneficiary.

      This program, called "TeleDiab" for the first time in our country, was designed in
      cooperation with the Istanbul University Rectorate and the local telecommunication company
      Turkcell. Its implementation was carried out as a pilot project in the Department of
      Endocrinology and Metabolic Diseases of Istanbul Medical Faculty in the follow-up and
      treatment of diabetic patients. Subjects are randomized to receive telemedicine case
      management or usual care for diabetes.

      This project, it is aimed to evaluate the "TeleDiab" program developed for use in diabetic
      patients in terms of applicability, practicality, effectiveness, and cost-effectiveness. In
      this way, it was aimed to compare the electronically followed patient group with a similar
      patient group routinely followed in terms of glycemic control, treatment compliance,
      complications, and comorbid diseases 6 months and 1 year later.

      The intervention utilizes a home telemedicine unit (HTU). The HTU is a specially designed,
      web-enabled device with a data port connected to a home glucometer and home blood pressure
      cuff whereby measurements obtained with these devices can be directly uploaded to a computer
      database. A diabetes nurse and a practitioner case manager interact regularly with
      intervention participants through videoconference via the HTU.
    

Intervention name(s): TeleDiab (Telemedicine); Usual care
Intervention type(s): Device; Other
Intervention description(s): TeleDiab program components consist of:
Electronic transmission of capillary blood glucose measurement results
Electronic transmission of blood pressure measurements
Synchronized video-conferencing, secure messaging
Access to clinical data from patient files when necessary
Reminding of routine follow-up tests and examinations
Providing web-based educational materials to patients.; Usual diabetes care, as provided by primary care providers
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Other
Keywords: Telemedicine; Telehealth; Virtual care; Diabetes; Virtual visits