Use of telemedicine platform improves blood sugar control in diabetes: Study
Many diabetic patients struggle in daily life to calculate and inject appropriate doses of basal and/or meal insulin, leading to episodes of hypo or hyperglycemia. Such inconvenience is aggravated by the frequent burden of their daily routine, including irregular activities and unexpected physical activity, as well as the difficulty of complying with prescheduled medical visits, without interfering with the needs of daily working activities. The DIABEO® system (DS) is a class IIb CE-marked medical device in Europe, which has been created to overcome some of the above hurdles.
A recent study published in the Diabetes Technology & Therapeutics on December 7, 2020, suggests that the use of the telemedicine platform DIABEO at least once a day significantly reduces blood sugar levels and HbA1c levels.
DIABEO (DS) is a telemedicine solution that combines a mobile app for patients with a web portal for health care providers that allows real-time monitoring of basal-bolus insulin therapy as well as therapeutic decision making of insulin treatment in BB-treated patients. DIABEO uses a validated algorithm to calculate insulin doses as a function of the glucose target defined by the physician, as well of the carbohydrate intake, current glycemia, and anticipated physical activity reported by the patient. The automatic algorithm ensures the adjustment of the insulin doses of bolus and basal insulin injections, or basal pump rates, when plasma postprandial or fasting glucose levels are off-target. Real-life studies have shown a very low rate of use of mobile health apps by patients. In type 2 diabetes, a recent real-life study showed that only 42% of participants actively used the My Dose Coachâ„¢ digital tool. Therefore, researchers conducted a randomized controlled trial to evaluate the efficacy of DS with the standard care in conditions close to real life.
TELESAGE was a multicenter, randomized, open study with three parallel arms which was conducted in real-life (pragmatic) conditions in France.
- • arm 1: standard care
- • arm 2: DIABEO alone
- • arm 3: DIABEO+telemonitoring by trained nurses
A total of 665 patients with either type 1 or type 2 diabetes, who were poorly controlled with intensive insulin therapy, delivered by multiple daily injections or by continuous subcutaneous insulin injection were included in the study. The major outcome assessed was the reduction in HbA1c levels after a 12-month follow-up.
Upon analysis, researchers found that participants who used DIABEO one or more times a day showed a significant and meaningful reduction in HbA1c versus standard of care at 12 months. They noted that DIABEO users included 25.1% of participants in arm 2 and 37.6% in arm 3 and the mean difference observed were −0.41% for arm 2—arm 1 and −0.51% for arm 3—arm 1. In an intention-to-treat analysis, they found the changes in HbA1c levels and the incidence of hypoglycemia were comparable between arms.
The authors concluded, "A clinically and statistically significant HbA1c reduction was observed in those patients who used DIABEO at least once a day. The reduction of HbA1c was even more important in patients who used DIABEO at least twice a day. The inclusion of a telemonitoring service by trained nurses expanded the use of DIABEO under real-life conditions. An analysis of predictive factors suggests that DIABEO could be particularly suitable for adults and older people with mildly uncontrolled diabetes, as well as for those living in rural areas.".
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