Managing diabetes mellitus in underserved subjects of Western China using a telemedicine system— A clinical trial

• 作者: Chuanqing Xie Jiao Bai Weiguo Ma Ya Li Yuanyuan Huo
• 来源期刊: 内分泌系统研究(英文)
• 学科: 医学
• 关键词: Clinical trial DIABETES care Insulin resistance Glycaemic control Type 2 DIABETES
• 年，卷（期）: 2019,（1）
• 页码范围: 16-24
• 页数: 9页
• 分类号: R58

摘要

Objective:To evaluate the effectiveness of Internet and telephone-based telemedicine system managing on patients’glycemic index,blood pressure,and lipid level control in underserved subjects with type 2 diabetes in Western China.Research designs and methods:In a 3 years,randomized,controlled,single-blind,parallel-group treat-to-target study,412 subjects with type 2 diabetes were randomized to telemedicine(Tel;n=208)group and usual care(control;n=204)group.We evaluated the effects of the intervention on blood sugar,blood pressure,and lipid levels at 1,2,3 years point,and investigated the cause of the loss during follow-up by phone call.Results:Intra-group comparison:in the Tel group,the FBS,2HPG,HbA1c,and SBP at 1,2,3 years and DBP,TC,TG,BMI at 2,3 years were significantly decreased compared with baseline level(P<0.05).Moreover,the Tel group had an obvious better control of their HbA1c at 2 and 3 years and 2HPG at 3 years of follow-up respectively compared with the outcomes at 1 year(P<0.05).Inter-group comparison:the FBS,2HPG,and HbA1c of Tel group decreased significantly from the baseline to the 1 year more than those of control group(P<0.05 or P<0.01).In this analysis,all clinical measures of Tel group had a significant downward compared with the outcomes of Control group at 2 years,the FBS,HbA1c and BMI(P<0.001),the 2HPG and SBP(P<0.01)and DBP,TC,and TG(P<0.05)were statistically significant respectively.Logistic regression analysis showed that the subject loss during follow-up was associated with worse diabetes management(OR=3.842),low income(OR=3.201),low education level(OR=0.923),and greater distance to the hospital(OR=0.921).Conclusions:The study results indicated that the telemedicine may be a useful tool for managing diabetes mellitus.