Web-based telemedicine for management of type 2 diabetes through glucose uploads: a randomized controlled trial. Telemedical care reduces hypoglycemias and improves glycemic control in children and adolescents with type 1 diabetes. A telephone-delivered intervention to improve glycemic control in type 2 diabetic patients. Diabetes intervention in the information age. A randomized controlled trial of the effect of real-time telemedicine support on glycemic control in young adults with type 1 diabetes (ISRCTN 46889446). Telemedicine in the Management of Type 2 Diabetes Mellitus A Telemedicine System That Includes a Personal Assistant Improves Glycemic Control in Pump-Treated Patients with Type 1 Diabetes Telemedicine improved diabetic management. An automated telemedicine system improves patient-reported well-being. Evaluation of a mobile phone telemonitoring system for glycaemic control in patients with diabetes Telemedicine influence on the follow-up of type 2 diabetes patients. Glycemic Control and Health Disparities in Older Ethnically Diverse Underserved Adults With Diabetes Smart Care Based on Telemonitoring and Telemedicine for Type 2 Diabetes Care: Multi-Center Randomized Controlled Trial. Real-time continuous glucose monitoring together with telemedical assistance improves glycemic control and glucose stability in pump-treated patients. Practical Telemedicine for Veterans with Persistently Poor Diabetes Control: A Randomized Pilot Trial. A randomized controlled trial of a nurse short-message service by cellular phone for people with diabetes. Active assistance technology reduces glycosylated hemoglobin and weight in individuals with type 2 diabetes: results of a theory-based randomized trial.
AIMS To evaluate the feasibility and effectiveness of a telemedicine system based on internet in the follow-up of patients with type 2 diabetes mellitus ( T2DM ) . METHODS A prospect i ve r and omized telemedicine study with two parallel groups was design ed . 114 patients diagnosed T2DM were r and omly divided into telemedicine group and traditional face-to-face visit group as control . 57 cases were included for each group . 108 patients completed the trial , in which 53 cases in telemedicine group and 55 cases in control group . Patients in telemedicine group were taught to use telemedicine software to upload their blood glucose and other metabolic information at home at least every 2 weeks , and the research ers gave proper advices according to patients ' key behaviors . The telemedicine interval is 3 months . RESULTS Compared to control group , telemedicine group exhibited better HbA1c and fasting blood glucose controlling ( P < 0.05 ) . Moreover , telemedicine intervention decreased hypoglycemia risk ( P = 0.044 ) , and contributed to levels of HbA1c less than 7 % which is the target of our study ( P = 0.049 ) . CONCLUSIONS Telemedicine system can provide a tighter glycemic control for the treatment of T2DM patients , especially in cases with difficulties to access to the medical centre Education programs for intensive insulin therapy were found to be valuable in improving glycemic control , but , due to low prevalence of type 1 diabetes in children and adolescents , access to those programs varies considerably in rural areas . We report on a telemedical care program that overcomes geographical isolation of patients on intensive insulin therapy . Sixty-one children and adolescents under the age of 26 participated in a telemedical care program . They stored daily information on blood glucose , injected insulin , meals and exercise  in a glucosemeter with electronic memory and transferred the data via modem go a remote diabetes center outside of the region . By individual telephone consultations from home , they review ed the data with a diabetologist at the diabetes center and adjusted their intensive insulin therapy in order to achieve predefined treatment goals . Patients were trained for 19 ( 6 - 48 ) weeks in the program and measured blood glucose 4.9 ( 1.7 - 4.9 ) times daily . Compared to the run-in-period , mean blood glucose had decreased ( 167 to 158 mg/dL , p < 0.01 ) , st and ard deviation of blood glucose had decreased ( 81 to 70 mg/dL , p < 0.001 ) , and frequency of hypoglycemia had decreased ( 5.2 to 3.3 in 4 weeks , p = 0.01 ) at the end of the program . The proportion of blood glucose values within the target range ( 80 - 180 mg/dL ) had increased ( 47 - 55 % , p < 0.001 ) . HbAlc was reduced by 0.4 % ( -3.8 to + 2.2 % , p < 0.05 ) . Telemedical care for intensive insulin therapy is safe , can improve glycemic control , and reduce the number of hypoglycemias in children and adolescents with type 1 diabetes This study was performed to investigate the effect of a telephone-delivered intervention on glycemic control and body mass index in Korean type 2 diabetic patients . 38 patients were r and omly selected , with 20 assigned to a telephone group and 18 to a control group . The goal of the intervention was to keep blood glucose concentrations close to the normal range . The intervention was applied to the telephone group for 12 weeks . It consisted of continuous education and reinforcement of diet , exercise and medication adjustment , as well as frequent self-monitoring of blood glucose levels . Telephone intervention was performed twice per week for the first month , and then weekly for the second and third months . Subjects were requested to write self- management logs , including blood glucose , diet and an exercise diary . The  diet diaries  were analyzed by a dietitian , and subjects instructed about the results by telephone counseling or mail . All medication adjustments were communicated to the subjects ' diabetes specialist . Glycosylated hemoglobin ( HbA1c ) , fasting blood glucose ( FBG ) and 2-hour postpr and ial glucose were measured before , and after , the intervention . Patients in the telephone group had a mean decrease of 1.2 % , with those in the control group having a mean increase of 0.6 % , in HbA1c . There were no significant differences in the body mass index ( BMI ) between the two groups . These findings indicated that a telephone-delivered intervention would improve HbA1c , but would not affect BMI Sustained improvement in blood glucose control is the only treatment outcome which will reduce or eliminate the long term complications of diabetes mellitus . We have design ed and evaluated an electronic information system which facilitates this task . The system is voice-interactive , physician directed and affords , to remote patients , 24 h access via touch-tone telephone . Accordingly , patients access the system each day to report self-measured blood glucose levels or hypoglycaemic symptoms together with dietary changes , planned exercise , stress , illness or other lifestyle events . In turn they receive immediate advice with respect to medication dosing changes , and other pertinent feedback . Preliminary system beta-testing for safety and efficacy was performed for one year in an open study of 204 patients derived from two independent , health-care environments . Among the two testing centres , over 60,000 telephone cells were received by the computer systems during the start-up year . Safety and efficacy expectations were met . In addition , prevalence of diabetes related crises ( hyperglycaemia or hypoglycaemia ) fell approximately 3-fold . Glycated haemoglobin fell significantly ( 1.0 - 1.3 % ) in patients actively using the system . In control groups of patients not actively using the system , there were no improvements in metabolic control while body weights were stable in all groups . The new system was safe and effective in our h and s and empowered our health professionals to provide improved diabetes care OBJECTIVE To determine whether a system of telemedicine support can improve glycemic control in type 1 diabetes . RESEARCH DESIGN AND METHODS A 9-month r and omized trial compared glucose self-monitoring real-time result transmission and feedback of results for the previous 24 h in the control group with real-time graphical phone-based feedback for the previous 2 weeks together with nurse-initiated support using a web-based graphical analysis of glucose self-monitoring results in the intervention group .  All patients aged 18 - 30 years with HbA(1c ) ( A1C ) levels of 8 - 11 % were eligible for inclusion . RESULTS A total of 93 patients ( 55 men ) with mean diabetes duration ( means + /- SD ) 12.1 + /- 6.7 years were recruited from a young adult clinic . In total , the intervention and control groups transmitted 29,765 and 21,400 results , respectively . The corresponding median blood glucose levels were 8.9 mmol/l ( interquartile range 5.4 - 13.5 ) and 10.3 mmol/l ( 6.5 - 14.4 ) ( P < 0.0001 ) . There was a reduction in A1C in the intervention group after 9 months from 9.2 + /- 1.1 to 8.6 + /- 1.4 % ( difference 0.6 % [ 95 % CI 0.3 - 1.0 ] ) and a reduction in A1C in the control group from 9.3 + /- 1.5 to 8.9 + /- 1.4 % ( difference 0.4 % [ 0.03 - 0.7 ] ) . This difference in change in A1C between groups was not statistically significant ( 0.2 % [ -0.2 to 0.7 , P = 0.3 ) . CONCLUSIONS Real-time telemedicine transmission and feedback of information about blood glucose results with nurse support is feasible and acceptable to patients , but to significantly improve glycemic control , access to real-time decision support for medication dosing and changes in diet and exercise may be required Objective To explore a model of Internet‐based integrated management of diabetes , we established a remote diabetes medical service platform ( U‐Healthcare ) and evaluated its effectiveness and practicality . Material s and Methods In total , 212 patients with type 2 diabetes mellitus were r and omly assigned to 2 groups . Data from the intervention group were automatically transmitted through a glucometer ; furthermore , this group received information regarding medicines , diet , exercise and other management through U‐Healthcare . The control group received conventional medical treatment without any additional intervention . All patients were regularly followed up every 3 months for half a year . Results At the 3‐month follow‐up , fasting plasma glucose levels of the intervention group were significantly lower than those at the baseline as well as those of the control group . Triglyceride levels of the intervention group were much lower than those at the baseline . At the 6‐month follow‐up , 2‐hour postpr and ial plasma glucose levels of the intervention group significantly improved compared with those of the control group . HbA1c levels gradually decreased every 3 months in the intervention group , and the mean change in the levels was significantly greater in this group than in the control group ( from 1.27‐0.68 % ) . At the end of the study , more than 80 % of the patients in the intervention group adhered to blood glucose monitoring 2‐3 days per week , and their compliance degree was 72 % . Conclusions The Internet‐based U‐Healthcare system of integrated management in diabetes not only achieved better glycemic control , effectively improved HbA1c levels and decreased triglyceride levels but also enhanced patients ’ adherence to the medical team 's instructions Background : The DIABTel system , a Web-based telemedicine application , integrates a whole communication system ( glucometer , insulin pump , wireless h and -held assistant ) for medical remote advice . We sought to evaluate , in terms of glycemic control , the DIABTel system in a r and omized crossover clinical study . Methods : Ten patients with type 1 diabetes [ 5 women , age 40.6 ( 21–62 ) years , diabetes duration 14.7 ( 3–52 ) years ] were included . During the 4-week active phase , data sent by patients were analyzed by the physician and modifications of the basal rate and bolus were advised in the following 24 hours . During the control phase , patients sent glucose data without any feedback from the medical center . Results : The mean numbers of daily glucose values and bolus sent by patients during the active period were 4.46 ± 0.91 and 4.58 ± 0.89 , respectively . The personal digital assistant functionalities used more frequently by patients were ( times per week ) data visualization ( 8.1 ± 6.8 ) , data download from the insulin pump ( 6.8 ± 3.3 ) , and synchronization with the telemedicine server ( 8.5 ± 4.9 ) . After the experimental phase , serum fructosamine decreased significantly ( 393 ± 32 vs 366 ± 25 μmol/liter ; p < 0.05 ) and hemoglobin A1c ( HbA1c ) tended to decrease ( 8.0 ± 0.6 vs 7.78 ± 0.6 ; p = 0.073 ) , whereas no changes were observed during the control phase . The number of treatment modifications proposed and performed by the patients correlated with the change observed in HbA1c during the active phase ( r = −0.729 , p = 0.017 ) . Conclusions : The DIABTel system , a telemedicine system that includes a wireless personal assistant for remote treatment advising , allows better glycemic control in pump-treated patients with type 1 diabetes . To our knowledge , this is the first study that demonstrates improved glycemic control with the use of a telemedicine system that incorporates insulin delivery data Effective control of diabetes is known to delay or prevent the end-organ complications of this disease . Can telemedicine improve a patient 's ability to self-manage diabetes  ? Twenty-eight patients entered a study comparing home telemedicine consultation with st and ard outpatient care . A nurse case manager contacted the telemedicine group once a week under the direction of a primary care physician , who contacted the telemedicine group once a month . Laboratory studies and total body weight were measured at the beginning and at the end of the 3-month study . The hemoglobin A1c ( HbA1c ) and total body weight improved significantly in the intervention ( telemedicine ) group , as shown by a 16 % reduction in mean HbA1c level ( from 9.5 to 8.2 % ) and a 4 % mean weight reduction ( from 214.3 to 206.7 pounds ) . Based on our experience , we present a functionally based telemedicine classification system to improve the application of electronic medicine in future studies BACKGROUND Control of serum glucose levels is essential for the reduction of complications of diabetes . Telemedicine is one strategy through which serum glucose control can be improved . METHODS A total of 35 adult , insulin-treated patients with diabetes ( type 1 and type 2 ) were enrolled in the present study ( 63.0 + /- 10 years of age , 63 % female ) and r and omized to telemedicine monitoring ( including cordless , remote glucose monitor , and transmitter , n =  17  ) , or conventional follow-up ( n = 18 ) . Metabolic parameters were evaluated , and a quality of life question naire was administered both pre- and post-treatment . RESULTS Groups were similar at baseline in terms of demographic , quality of life , and metabolic parameters . Significant differences in post-treatment metabolic parameters were not observed , although serum glucose was marginally elevated in the control group compared to the telemedicine group ( 214 + /- 65 mg/dL vs. 171 + /- 77 mg/dL , P = 0.09 ) . On the other h and , being clinical ly symptom-free ( 71 % vs. 11 % , P = 0.003 ) , having no hypoglycemic events ( 82 % vs. 17 % , P = 0.0001 ) , and having no hyperglycemic events ( 65 % vs. 17 % , P = 0.004 ) were all significantly more frequently reported in the telemedicine group compared to the control group . Compared to the control group , the telemedicine group reported experiencing significantly less anxiety , treatment difficulty , depression , disease-associated life complications , and feelings of impotence or ineptitude and significantly greater improvement in personal control over glucose , weight , and overall diabetes . CONCLUSIONS Though post-treatment metabolic differences were not observed between treatment groups , the telemedicine group reported significantly greater post-treatment experiences of improved quality of life and sense of control over the disease . Thus patient satisfaction can be enhanced through the use of telemedicine We conducted a r and omized controlled trial using mobile health technology in an ethnically diverse sample of 137 patients with complicated diabetes . Patients in the intervention group ( n = 72 ) were trained to measure their blood glucose with a sensor which transmitted the readings to a mobile phone via a Bluetooth wireless link . Clinicians were then able to examine and respond to the readings which were viewed with a web-based application . Patients in the control arm of the study ( n = 65 )  did not transmit their readings and received care with their usual doctor in the outpatient and /or primary care setting . The mean follow-up period was 9 months in each group . The default rate was higher in the patients in the intervention arm due to technical problems . In an intention-to-treat analysis there were no differences in HbA1c between the intervention and control groups . In a sub-group analysis of the patients who completed the study , the telemonitoring group had a lower HbA1c than those in the control group : 7.76 % and 8.40 % , respectively ( P = 0.06 ) OBJECTIVE This study was design ed to evaluate the impact of a teleassistance system on the metabolic control of type 2 diabetes patients . RESEARCH DESIGN AND METHODS We conducted a 1-year controlled parallel-group trial comparing patients r and omized ( 1 ) to an intervention group , assigned to a teleassistance system using real-time transmission of blood glucose results , with immediate reply when necessary , and telephone consultations , or ( 2 ) to a control group , being regularly followed-up at their healthcare center . Study subjects were type 2 diabetes patients > 30 years of age followed in the primary care setting . RESULTS A total of 328 type 2 diabetes patients were recruited from 35 family practice s in the province of Málaga , Spain . There was a reduction in hemoglobin A1c after 12 months from 7.62 + /- 1.60 % to 7.40 + /- 1.43 % ( P = 0.027 ) in the intervention group and from 7.44 + /- 1.31 % to 7.35 + /- 1.38 % ( P = 0.303 ) in the control group . The difference in the change between groups was not statistically significant . There was also a significant decrease in systolic and diastolic blood pressure , total cholesterol , low-density lipoprotein cholesterol , and body mass index in the intervention group . In the control group , the only significant decline was in low-density lipoprotein cholesterol . CONCLUSIONS A teleassistance system using real-time transmission of blood glucose results with an option to make telephone consultations is feasible in the primary care setting as a support tool for family physicians in their follow-up of type 2 diabetes patients OBJECTIVE The Informatics for Diabetes Education and Telemedicine ( IDEATel ) project r and omized ethnically diverse underserved older adults with diabetes to a telemedicine intervention or usual care .  Intervention participants had lower A1C levels over 5 years . New analyses were performed to help better underst and this difference . RESEARCH DESIGN AND METHODS IDEATel r and omized Medicare beneficiaries with diabetes ( n = 1,665 ) to receive home video visits with a diabetes educator and upload glucose levels every 4–6 weeks or usual care ( 2000–2007 ) . Annual measurements included BMI , A1C ( primary outcome ) , and completion of question naires . Mixed-model analyses were performed using r and om effects to adjust for clustering within primary care physicians . RESULTS At baseline , A1C levels  ( mean ± SD ) were 7.02 ± 1.25 % in non-Hispanic whites ( n = 821 ) , 7.58 ± 1.78 % in non-Hispanic blacks ( n = 248 ) , and 7.79 ± 1.68 % in Hispanics ( n = 585 ) . Over time , lower A1C levels were associated with more glucose uploads ( P = 0.02 ) and female sex ( P = 0.002 ) . Blacks , Hispanics , and insulin-users had higher A1C levels than non-Hispanic whites ( P < 0.0001 ) . BMI was not associated with A1C levels . Blacks and Hispanics had significantly fewer uploads than non-Hispanic whites over time . Hispanics had the highest baseline A1C levels and showed the greatest improvement in the intervention , but , unlike non-Hispanic whites , Hispanics did not achieve A1C levels < 7.0 % at 5 years . CONCLUSIONS Racial/ethnic disparities were observed in this cohort of underserved older adults with diabetes . The IDEATel telemedicine intervention was associated with improvement in glycemic control , particularly in Hispanics , who had the highest baseline A1C levels , suggesting that telemedicine has the potential to help reduce disparities in diabetes management BACKGROUND This study was performed to determine the effectiveness of the Smart Care service on glucose control based on telemedicine and telemonitoring compared with conventional treatment in patients with type 2 diabetes . MATERIAL S AND METHODS This 24-week prospect i ve multi-center r and omized controlled trial involved 338 adult patients with type 2 diabetes at four university hospitals in South Korea . The patients were r and omly assigned to a control group ( group A , n = 113 ) , a telemonitoring group ( group B , n = 113 ) , or a telemedicine group ( group C , n = 112 ) . Patients in the telemonitoring group visited the outpatient clinic regularly , accompanied by an additional telemonitoring service that included remote glucose monitoring with automated patient decision support by text . Remote glucose monitoring was identical in the telemedicine group , but assessment by outpatient visits was replaced by video conferencing with an endocrinologist . RESULTS The adjusted net reductions in HbA1c concentration after 24 weeks were similar in the conventional , telemonitoring , and telemedicine groups ( -0.66 % ± 1.03 % vs. -0.66 % ± 1.09 % vs. -0.81 % ± 1.05 % ; p > 0.05 for each pairwise comparison ) . Fasting glucose concentrations were lower in the telemonitoring and telemedicine groups than in the conventional group . Rates of hypoglycemia were lower in the telemedicine group than in the other two groups , and compliance with medication was better in the telemonitoring and telemedicine than in the conventional group . No serious adverse events were associated with telemedicine . CONCLUSIONS Telehealthcare was as effective as conventional care at improving glycemia in patients with type 2 diabetes without serious adverse effects BACKGROUND Real-time continuous glucose monitoring ( CGM ) has recently been incorporated into routine diabetes management because of the potential advantages it offers for glycemic control . The aim of our study was to evaluate the impact of the use of real-time CGM together with a telemedicine system in hemoglobin A1c and glucose variability in patients with type 1 diabetes treated with insulin pumps . METHODS Ten patients ( five women , 41.2 [ range , 21 - 62 ] years old , duration of diabetes 14.9 [ range , 3 - 52 ] years ) were included in this r and omized crossover study . Patients used the DIABTel telemedicine system throughout the study , and real-time CGM was used for 3 days every week during the intervention phase . At the end of the control phase , a blind 3-day CGM was performed . Glucose variability was evaluated using the Glucose Risk Index ( GRI ) , a comparative analysis of continuous glucose values over two consecutive hours . RESULTS Hemoglobin A1c decreased significantly ( 8.1 + /- 1.1 % vs. 7.3 + /- 0.8 % ; P = 0.007 ) after the intervention phase , while no changes were observed during the control phase . The mean number of daily capillary glucose readings was higher during the intervention phase ( 4.7 + /- 1.1 vs. 3.8 + /- 1.0 ; P < 0.01 ) , because of an increase in r and om analyses ( 1.22 + /- 0.3 vs. 0.58 + /- 0.1 ; P < 0.01 ) , and there was also a significant increase in the mean number of bolus doses per day ( 5.23 + /- 1.1 vs. 4.4 + /- 0.8 ; P < 0.05 ) . The GRI was higher during the control phase than during the experimental phase ( 9.6 vs. 6.25 ; P < 0.05 ) . CONCLUSIONS Real-time CGM in conjunction with the DIABTel system improves glycemic control and glucose stability in pump-treated patients with type 1 diabetes BACKGROUND Telemedicine-based diabetes management improves outcomes versus clinic care but is seldom implemented by healthcare systems . In order to advance telemedicine-based management as a practical option for veterans with persistent poorly controlled diabetes mellitus ( PPDM ) despite clinic-based care , we evaluated a comprehensive telemedicine intervention that we specifically design ed for delivery using existing Veterans Health Administration ( VHA ) clinical staffing and equipment . MATERIAL S AND METHODS We conducted a 6-month r and omized trial among 50 veterans with PPDM ; all maintained hemoglobin A1c ( HbA1c ) levels continuously > 9.0 % for > 1 year despite clinic-based management . Participants received usual care or a telemedicine intervention combining telemonitoring , medication management , self-management support , and depression management ; existing VHA clinical staff delivered the intervention . Using linear mixed models , we examined HbA1c , diabetes self-care ( measured by the Self-Care Inventory-Revised question naire ) , depression , and blood pressure . RESULTS At baseline , the model-estimated common HbA1c intercept was 10.5 % . By 6 months , estimated HbA1c had improved by 1.3 % for intervention participants and 0.3 % for usual care ( estimated difference , -1.0 % , 95 % confidence interval [ CI ] , -2.0 % , 0.0 % ; p = 0.050 ) . Intervention participants ' diabetes self-care ( estimated difference , 7.0 ; 95 % CI , 0.1 , 14.0 ; p = 0.047 ) , systolic blood pressure ( -7.7 mm Hg ; 95 % CI , -14.8 , -0.6 ; p = 0.035 ) , and diastolic blood pressure ( -5.6 mm Hg ; 95 % CI , -9.9 , -1.2 ; p = 0.013 ) were improved versus usual care by 6 months . Depressive symptoms were similar between groups . CONCLUSIONS A comprehensive telemedicine intervention improved outcomes among veterans with PPDM despite clinic-based care . Because we specifically design ed this intervention with scalability in mind , it may represent a practical , real-world strategy to reduce the burden of poor diabetes control among veterans BACKGROUND Nurse 's education using telemedicine results in a decrease in blood glucose levels in patients with type 2 diabetes . OBJECTIVE To investigate the effectiveness of an educational intervention that used both the cellular phone and the Internet to provide a short-messaging service ( SMS ) relating to plasma glucose levels . METHODS Twenty-five patients were r and omly assigned to an intervention group and 26 to a control group . The intervention was applied for 12 weeks . The goal of the intervention was to keep blood glucose concentrations close to the normal range . Patients in the intervention group were asked to access a website by using a cellular phone or to wiring the Internet and input their blood glucose levels every day . Participants were sent the optimal recommendations by both cellular phone and the Internet weekly . RESULTS Patients in the intervention group had a mean decrease in glycosylated haemoglobin ( HbA(1)c ) levels of 1.15 % and those in the control group had a mean increase of HbA(1)c levels of 0.07 % ( p=0.005 ) . There was a significant mean change in the 2hrs post-meal glucose ( 2HPMG ) level for the intervention group ( p<0.05 ) , with a mean change of -4.7mmol/l . The mean change in the control group was not significant . CONCLUSION This educational intervention using the Internet and an SMS by cellular phone improved levels of HbA(1)c and 2HPMG BACKGROUND Type 2 diabetes is an individual health challenge requiring ongoing self-management . Remote patient reporting of relevant health parameters and linked automated feedback via mobile telephone have potential to strengthen self-management and improve outcomes . This research involved development and evaluation of a mobile telephone-based remote patient reporting and automated telephone feedback system , guided by health behavior change theory , aim ed at improving self-management and health status in individuals with type 2 diabetes . SUBJECTS AND METHODS This research comprised a r and omized controlled trial . Inclusion criteria were diagnosis of type 2 diabetes , elevated glycosylated hemoglobin ( HbA1c ) levels ( range , 6.5 - 11 % ) or use of oral diabetes medication , and 30 - 70 years of age . Intervention subjects ( n=24 ) participated in remote patient reporting of health status parameters and linked health behavior change feedback . Control participants ( n=24 ) received st and ard of care including diabetes education and healthcare provider counseling . Patients were followed for approximately 10 months . RESULTS Intervention participants achieved , compared with controls and controlling for baseline , a significantly greater mean reduction in HbA1c of -0.40 % ( 95 % confidence interval [ CI ] -0.67 % to -0.14 % ) versus 0.036 % ( 95 % CI -0.23 % to 0.30 % ) ( P<0.03 ) and significantly greater weight reduction of -2.1 kg ( 95 % CI -3.6 to -0.6 kg ) versus 0.4 kg ( 95 % CI -1.1 to 1.9 kg ) . Nonsignificant trends for greater intervention compared with control improvement in systolic and diastolic blood pressure were observed . CONCLUSIONS Sophisticated information technology platforms for remote patient reporting linked with theory-based health behavior change automated feedback have potential to improve patient outcomes in type 2 diabetes and merit scaled-up research efforts
Discussion Compared to usual care , the use of telemedicine was found to improve HbA1c and reduce the risk of moderate hypoglycaemia  in diabetic patients , but without significant difference in BMI
Introduction Hypoglycaemia is a clinical syndrome from various causes , which happens when the blood glucose concentration is too low .
Many studies show that telemedicine intervention can improve glycemic control and has a positive impact on the management of diabetic patients .
The purpose of this study was to evaluate the effect of telemedicine intervention on hypoglycemic event occurrences and results on hemoglobin A1c ( HbA1c ) and body mass index ( BMI ) .