Home telecare during intensive insulin treatment – metabolic control does not improve as much as expected

Abstract

We examined the influence of the increased frequency of data reporting on metabolic control in patients with diabetes. Data reporting was via a home telecare system that stored blood glucose values and was integrated with a simple electronic logbook. The data collected by the patient were automatically transmitted via the telephone network every night. The study population consisted of 30 patients with type I diabetes, who were randomly allocated to the home telecare group or the control group. The control group was treated based on clinical examinations performed every three weeks. In the home telecare group, the patient-collected data were transmitted to hospital daily, enabling more frequent interventions by the doctor. The average study period was 180 days (SD 22) in the home telecare group and 176 days (SD 16) in the control group. The mean level of metabolic control and the insulin dose adjustment patterns were very similar in both groups regardless of the much higher (15 times) reporting frequency in the home telecare group. The patient-collected data were not fully utilized, mainly because of too high within-day variability in glycaemic control and the high workload connected with daily data analysis.