Effects of remote care of patients with poorly controlled type 1 diabetes included in an experimental telemonitoring programme
To assess, in a real-life setting, the effectiveness of telemonitoring adults with type 1 diabetes (T1D) using continuous glucose monitoring in a telemedicine experiment. Experimentation in Telemedicine for the Improvement of Healthcare Pathways (ETAPES), an experimental telehealth programme for fiv...
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| Veröffentlicht in: | Diabetes & metabolism 2021-11, Vol.47 (6), p.101251-101251, Article 101251 |
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| container_title | Diabetes & metabolism |
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| creator | Gaudillère, M. Pollin-Javon, C. Brunot, S. Villar Fimbel, S. Thivolet, C. |
| description | To assess, in a real-life setting, the effectiveness of telemonitoring adults with type 1 diabetes (T1D) using continuous glucose monitoring in a telemedicine experiment.
Experimentation in Telemedicine for the Improvement of Healthcare Pathways (ETAPES), an experimental telehealth programme for five chronic diseases, is supported by the French national healthcare system to promote telemedical care. Using data from a single university hospital centre, 72 adults were studied, including 42 subjects (58%) receiving insulin pump therapy and 30 (42%) receiving multiple daily injections, with a median age of 35.5 years [28.0; 45.0] and poorly controlled type 1 diabetes (T1D) with a mean ± standard error of mean (SEM) HbA1c value of 8.69 ± 0.13%. The primary study outcome was the difference in HbA1c values between baseline and the end of a 6-month follow-up. Other end points of interest were mean blood glucose, glucose management indicator (GMI) level and % time in range (3.9–10 mmol/L) or below or above range.
At month 6, mean HbA1c levels were significantly reduced by −0.5% (P |
| doi_str_mv | 10.1016/j.diabet.2021.101251 |
| format | Article |
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Experimentation in Telemedicine for the Improvement of Healthcare Pathways (ETAPES), an experimental telehealth programme for five chronic diseases, is supported by the French national healthcare system to promote telemedical care. Using data from a single university hospital centre, 72 adults were studied, including 42 subjects (58%) receiving insulin pump therapy and 30 (42%) receiving multiple daily injections, with a median age of 35.5 years [28.0; 45.0] and poorly controlled type 1 diabetes (T1D) with a mean ± standard error of mean (SEM) HbA1c value of 8.69 ± 0.13%. The primary study outcome was the difference in HbA1c values between baseline and the end of a 6-month follow-up. Other end points of interest were mean blood glucose, glucose management indicator (GMI) level and % time in range (3.9–10 mmol/L) or below or above range.
At month 6, mean HbA1c levels were significantly reduced by −0.5% (P < 0.001) as were also mean blood glucose levels (P = 0.015), with a significant increase of 6.75 ± 1.36% of time in range at month 3 and of 4.98 ± 1.4% at month 6. Such improvements did not depend on age, gender or type of insulin therapy, but were inversely correlated to initial HbA1c values on multivariate analysis (P < 0.001).
Although the use of telehealth monitoring offers efficacy and safety in the metabolic control of patients with T1D, it does not fulfil all of these patients’ clinical needs. As such, this new healthcare pathway cannot replace, but is a useful complement to, face-to-face in-person clinical visits.</description><identifier>ISSN: 1262-3636</identifier><identifier>EISSN: 1878-1780</identifier><identifier>DOI: 10.1016/j.diabet.2021.101251</identifier><identifier>PMID: 33862199</identifier><language>eng</language><publisher>France: Elsevier Masson SAS</publisher><subject>Adult ; Blood Glucose - metabolism ; Blood Glucose Self-Monitoring ; CGM ; Diabetes Mellitus, Type 1 - therapy ; Glycated Hemoglobin A - analysis ; Humans ; Insulin - therapeutic use ; Insulin Infusion Systems ; Telemedicine ; Telemonitoring ; Type 1 diabetes</subject><ispartof>Diabetes & metabolism, 2021-11, Vol.47 (6), p.101251-101251, Article 101251</ispartof><rights>2021 Elsevier Masson SAS</rights><rights>Copyright © 2021 Elsevier Masson SAS. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c408t-aabcdb202b0ad905be516b63fe86ec115b7b2dc68d2c61e9c7de021c6b2a016d3</citedby><cites>FETCH-LOGICAL-c408t-aabcdb202b0ad905be516b63fe86ec115b7b2dc68d2c61e9c7de021c6b2a016d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.diabet.2021.101251$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,777,781,3537,27905,27906,45976</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33862199$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gaudillère, M.</creatorcontrib><creatorcontrib>Pollin-Javon, C.</creatorcontrib><creatorcontrib>Brunot, S.</creatorcontrib><creatorcontrib>Villar Fimbel, S.</creatorcontrib><creatorcontrib>Thivolet, C.</creatorcontrib><title>Effects of remote care of patients with poorly controlled type 1 diabetes included in an experimental telemonitoring programme</title><title>Diabetes & metabolism</title><addtitle>Diabetes Metab</addtitle><description>To assess, in a real-life setting, the effectiveness of telemonitoring adults with type 1 diabetes (T1D) using continuous glucose monitoring in a telemedicine experiment.
Experimentation in Telemedicine for the Improvement of Healthcare Pathways (ETAPES), an experimental telehealth programme for five chronic diseases, is supported by the French national healthcare system to promote telemedical care. Using data from a single university hospital centre, 72 adults were studied, including 42 subjects (58%) receiving insulin pump therapy and 30 (42%) receiving multiple daily injections, with a median age of 35.5 years [28.0; 45.0] and poorly controlled type 1 diabetes (T1D) with a mean ± standard error of mean (SEM) HbA1c value of 8.69 ± 0.13%. The primary study outcome was the difference in HbA1c values between baseline and the end of a 6-month follow-up. Other end points of interest were mean blood glucose, glucose management indicator (GMI) level and % time in range (3.9–10 mmol/L) or below or above range.
At month 6, mean HbA1c levels were significantly reduced by −0.5% (P < 0.001) as were also mean blood glucose levels (P = 0.015), with a significant increase of 6.75 ± 1.36% of time in range at month 3 and of 4.98 ± 1.4% at month 6. Such improvements did not depend on age, gender or type of insulin therapy, but were inversely correlated to initial HbA1c values on multivariate analysis (P < 0.001).
Although the use of telehealth monitoring offers efficacy and safety in the metabolic control of patients with T1D, it does not fulfil all of these patients’ clinical needs. As such, this new healthcare pathway cannot replace, but is a useful complement to, face-to-face in-person clinical visits.</description><subject>Adult</subject><subject>Blood Glucose - metabolism</subject><subject>Blood Glucose Self-Monitoring</subject><subject>CGM</subject><subject>Diabetes Mellitus, Type 1 - therapy</subject><subject>Glycated Hemoglobin A - analysis</subject><subject>Humans</subject><subject>Insulin - therapeutic use</subject><subject>Insulin Infusion Systems</subject><subject>Telemedicine</subject><subject>Telemonitoring</subject><subject>Type 1 diabetes</subject><issn>1262-3636</issn><issn>1878-1780</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kUtP3DAUha0KVCjwD6rKSzaZ2s7ESTaVKjRQJKRuYG35cTP1yIlT29MyG347dxTaJSs_7rnn-nwm5DNnK864_LpbOa8NlJVggh-vRMM_kHPetV3F246d4F5IUdWylmfkU847hpq-7j6Ss7rupOB9f05eNsMAtmQaB5pgjAWo1QmOx1kXDxOW_vryi84xpnCgNk4lxRDA0XKYgXK6vAIy9ZMNe4cFP1E9UXieIfkRHXSgBQKaT77E5KctnVPcJj2OcElOBx0yXL2tF-TpdvN486N6-Hl3f_P9obJr1pVKa2OdwaCGadezxkDDpZH1AJ0Ey3ljWiOclZ0TVnLobesAqVhphEZWrr4g14svTv69h1zU6LOFEPQEcZ8VsltLVreiQel6kdoUc04wqBlj6HRQnKkjebVTS2Z1JK8W8tj25W3C3ozg_jf9Q42Cb4sAMOcfD0lli3wtOJ_wB5SL_v0Jr5CqmVw</recordid><startdate>202111</startdate><enddate>202111</enddate><creator>Gaudillère, M.</creator><creator>Pollin-Javon, C.</creator><creator>Brunot, S.</creator><creator>Villar Fimbel, S.</creator><creator>Thivolet, C.</creator><general>Elsevier Masson SAS</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202111</creationdate><title>Effects of remote care of patients with poorly controlled type 1 diabetes included in an experimental telemonitoring programme</title><author>Gaudillère, M. ; Pollin-Javon, C. ; Brunot, S. ; Villar Fimbel, S. ; Thivolet, C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c408t-aabcdb202b0ad905be516b63fe86ec115b7b2dc68d2c61e9c7de021c6b2a016d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Blood Glucose - metabolism</topic><topic>Blood Glucose Self-Monitoring</topic><topic>CGM</topic><topic>Diabetes Mellitus, Type 1 - therapy</topic><topic>Glycated Hemoglobin A - analysis</topic><topic>Humans</topic><topic>Insulin - therapeutic use</topic><topic>Insulin Infusion Systems</topic><topic>Telemedicine</topic><topic>Telemonitoring</topic><topic>Type 1 diabetes</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gaudillère, M.</creatorcontrib><creatorcontrib>Pollin-Javon, C.</creatorcontrib><creatorcontrib>Brunot, S.</creatorcontrib><creatorcontrib>Villar Fimbel, S.</creatorcontrib><creatorcontrib>Thivolet, C.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Diabetes & metabolism</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gaudillère, M.</au><au>Pollin-Javon, C.</au><au>Brunot, S.</au><au>Villar Fimbel, S.</au><au>Thivolet, C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effects of remote care of patients with poorly controlled type 1 diabetes included in an experimental telemonitoring programme</atitle><jtitle>Diabetes & metabolism</jtitle><addtitle>Diabetes Metab</addtitle><date>2021-11</date><risdate>2021</risdate><volume>47</volume><issue>6</issue><spage>101251</spage><epage>101251</epage><pages>101251-101251</pages><artnum>101251</artnum><issn>1262-3636</issn><eissn>1878-1780</eissn><abstract>To assess, in a real-life setting, the effectiveness of telemonitoring adults with type 1 diabetes (T1D) using continuous glucose monitoring in a telemedicine experiment.
Experimentation in Telemedicine for the Improvement of Healthcare Pathways (ETAPES), an experimental telehealth programme for five chronic diseases, is supported by the French national healthcare system to promote telemedical care. Using data from a single university hospital centre, 72 adults were studied, including 42 subjects (58%) receiving insulin pump therapy and 30 (42%) receiving multiple daily injections, with a median age of 35.5 years [28.0; 45.0] and poorly controlled type 1 diabetes (T1D) with a mean ± standard error of mean (SEM) HbA1c value of 8.69 ± 0.13%. The primary study outcome was the difference in HbA1c values between baseline and the end of a 6-month follow-up. Other end points of interest were mean blood glucose, glucose management indicator (GMI) level and % time in range (3.9–10 mmol/L) or below or above range.
At month 6, mean HbA1c levels were significantly reduced by −0.5% (P < 0.001) as were also mean blood glucose levels (P = 0.015), with a significant increase of 6.75 ± 1.36% of time in range at month 3 and of 4.98 ± 1.4% at month 6. Such improvements did not depend on age, gender or type of insulin therapy, but were inversely correlated to initial HbA1c values on multivariate analysis (P < 0.001).
Although the use of telehealth monitoring offers efficacy and safety in the metabolic control of patients with T1D, it does not fulfil all of these patients’ clinical needs. As such, this new healthcare pathway cannot replace, but is a useful complement to, face-to-face in-person clinical visits.</abstract><cop>France</cop><pub>Elsevier Masson SAS</pub><pmid>33862199</pmid><doi>10.1016/j.diabet.2021.101251</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Diabetes & metabolism, 2021-11, Vol.47 (6), p.101251-101251, Article 101251 |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Adult Blood Glucose - metabolism Blood Glucose Self-Monitoring CGM Diabetes Mellitus, Type 1 - therapy Glycated Hemoglobin A - analysis Humans Insulin - therapeutic use Insulin Infusion Systems Telemedicine Telemonitoring Type 1 diabetes |
| title | Effects of remote care of patients with poorly controlled type 1 diabetes included in an experimental telemonitoring programme |
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