Long-term sustainability of metabolic compensation in telemedicine use – results of 18 months follow-up

Czech version

Authors: Jozef Lacka ¹; Pavol Košík ²; Klaudia Mesíková ³
Authors‘ workplace: JAL, s. r. o., Trnava ¹; Lekárska fakulta UK v Bratislave ²; Oddelenie biomedicínskeho výskumu FN s poliklinikou F. D. Roosevelta, Banská Bystrica ³
Published in: Diab Obez 2024; 24(1): 62-69
Category: Reviews

Overview

Introduction: The disparity between the number of healthcare professionals and the increasing number of patients with T2DM places increased demands on patient management. The solution requires the involvement of innovative technologies, including telemedicine. Parameters are measurable in the home environment (self-monitoring of glycemia, blood pressure, ECG, weight, oximetry, spirometry) by the patient themselves and the measured data can be transmitted by appropriate technology. Methods: In a prospective, non-interventional, clinical follow-up conducted in the conditions of routine clinical practice in a diabetes outpatient clinic, we followed patients with T2DM. The follow-up was carried out in the period from June 1, 2022 to December 31, 2023. Data were statistically processed using t-test, F-test and χ² test. Data are presented as mean [+SD (standard deviation)], numbers or proportions. Kaplan-Meier analysis of surviving patients was performed. Results: 216 patients were included in the telemedicine follow-up, 109 women (51.66%) and 102 men (48.34%). The mean age was 62 years for women and 57 years for men. The number of patients varied during the follow-up. The mean duration of use of the set was 8.8 months. 7 patients returned the set within the first week. Approximately 25% of the patients contacted refused the device. After adjusting glycemias after lunch and in the evening, we observed the best improvement after 6 months of intervention, with glycemias increasing slightly with time but not exceeding baseline values. HbA_1c (baseline 7.83% DCCT) initial improvement (6.85% DCCT) was maintained in the optimal range for 18 months in the long term. Using the telemedicine kit, 42.5% of patients achieve HbA_1c < 7% DCCT and 23.3% of patients have HbA_1c > 9% DCCT. In females, the decrease in body weight from 85.30 kg to 84.0 kg was greater compared to males, 98.26 kg to 97.46 kg, a decrease of -1.53 vs 0.83%. Patient monitored their blood pressure the most with all measurements. Most of the patients had it in the optimal range. Conclusion: After data transfer, the physician can proactively change treatments and recommendations without the immediate need for an in-person visit to the healthcare facility, thus reducing the time to make a relevant medical decision and its implementation by the patient.

Keywords:

compliance – Telemedicine – adherence – selfmonitoring – diabetes mellitus (T2DM)

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