Are Complications Preventable with Periodic Education via Telemedicine? A Study of 414 Compliant T2D Patients Followed Up for 19 Years

Background: Despite availability of many new diabetes therapies, outcomes still remain very poor, with majority developing debilitating vascular complications. Landmark trials have demonstrated, complications could be prevented if patients keep achieving A1c, BP and cholesterol targets. Diabetes Tele Management System (DTMS®), a sophisticated software integrated with multidisciplinary team was initiated in our centre since 1998 for customised titration of medications, diabetes education (DE) and behavioural modifications through virtual consultations (VC) precluding frequent physical visits (PV). Aim: To assess long-term impact of DTMS® over 19 years,in successfully averting complications in T2D. Methods: Patients enrolled in DTMS® and adhering to customised VC, with follow-up data available for 19 years were de-identified. Subjects: n 414, baseline:age 50.10±9.22y, males 60.09%, T2D duration 11.44±6.85y Inclusion criteria: VC ≥ 1 in 3 mths, PV ≥ 1 in 3y, and attended group DE ≥ 1 in 3y. Exclusion criteria: CKD (4and5). Results: Change from baseline at 19th y: A1c= -0.68%, LDL=-60.3 mg/dl, creatinine= 0.04 mg/dl, SBP/DBP= -7.2/-8.66 mmHg. New onset CKD= 0.24%, CAD/CVA=2.4%, deaths=3.86%. Average PV frequency 2.04/y, VC 1.2/month. Conclusion: Vascular complications could be successfully prevented, in 93.5% of the T2D subjects followed up for 19 years via tele-management program.