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首页> 外文期刊>Diabetes technology & therapeutics >Cost-effective use of telemedicine and self-monitoring of blood glucose via Diabetes Tele Management System (DTMS) to achieve target glycosylated hemoglobin values without serious symptomatic hypoglycemia in 1,000 subjects with type 2 diabetes mellitus - A retrospective study
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Cost-effective use of telemedicine and self-monitoring of blood glucose via Diabetes Tele Management System (DTMS) to achieve target glycosylated hemoglobin values without serious symptomatic hypoglycemia in 1,000 subjects with type 2 diabetes mellitus - A retrospective study

机译：通过糖尿病远程管理系统（DTMS）以经济有效的方式使用远程医疗和自我监测血糖，以在没有严重症状性低血糖的情况下在1,000名2型糖尿病患者中实现目标糖基化血红蛋白值-一项回顾性研究

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Objective: This study assessed the effectiveness, safety, and costs of the Diabetes Tele Management System (DTMS?; Dr. Jothydev Kesavadev, Jothydev's Diabetes and Research Center, Kerala, India)-based health care in type 2 diabetes (T2D) patients in South India. Research Design and Methods: We conducted a retrospective cohort study using electronic health records in our Center. The study sample comprised T2D patients enrolled in DTMS-based management, 30-75 years old, eligible for a glycosylated hemoglobin (HbA1c) target <6.5% and actively participating in various components of DTMS such as regular reporting of self-monitoring of blood glucose (SMBG) values and dose adjustments via telemedicine. We analyzed HbA1c, lipid profile, and other parameters measured at the first visit and on subsequent physical visits at months 3 and 6 and estimated the incidence of hypoglycemia. Results: We analyzed records of 1,000 subjects with 6-month follow-up data (mean age, 53.2±9.8 years; 64% male). Patients had an average of 17±2 telemedicine follow-ups and reported 66,745 SMBG values over 6 months. The mean±SD HbA1c value was 8.5±1.4% at the initial visit and was reduced to 6.3±0.6% at 6 months (P<0.0001). The rate of SMBG values <70 mg/dL was approximately 0.04/patient/month, with 84% patients reporting no hypoglycemia. The recurring extra cost to patient for DTMS, not considering cost of oral drugs and insulin, was equivalent to 9.66 U.S. dollars/month. Conclusions: DTMS, based on telemedicine follow-up and multidisciplinary care with SMBG-based monitoring, appears to be safe and cost-effective in the intensive treatment of T2D without serious co-morbidities. This system also avoids limitations of a traditional health care such as the need for very frequent physical visits for each and every drug dose adjustment, diet, and exercise advice.
机译：目的：本研究评估了基于糖尿病远程管理系统（DTMS？），Jothydev Kesavadev博士（印度喀拉拉邦Jothydev糖尿病与研究中心）在2型糖尿病（T2D）患者中的医疗保健。印度南部。研究设计和方法：我们使用中心的电子健康记录进行了回顾性队列研究。该研究样本包括30-75岁参加DTMS管理的T2D患者，符合糖化血红蛋白（HbA1c）目标<6.5％的条件，并积极参与DTMS的各个组成部分，例如定期自我报告血糖自我监测（SMBG）值和通过远程医疗进行剂量调整。我们分析了HbA1c，血脂谱和其他参数，这些参数在第3个月和第6个月的首次访问以及随后的物理访问中进行了测量，并估计了低血糖的发生率。结果：我们分析了1,000名受试者的记录，并进行了6个月的随访（平均年龄为53.2±9.8岁;男性为64％）。患者平均接受了17±2次远程医疗随访，并在6个月内报告了66,745个SMBG值。初诊时的平均±SD HbA1c值为8.5±1.4％，6个月时降至6.3±0.6％（P <0.0001）。 SMBG值<70 mg / dL的发生率约为0.04 /患者/月，其中84％的患者未发生低血糖。不考虑口服药物和胰岛素的费用，DTMS给患者带来的经常性额外费用相当于每月9.66美元。结论：基于远程医疗随访和基于SMBG监测的多学科护理的DTMS在强化治疗T2D且无严重合并症的情况下似乎是安全且具有成本效益的。该系统还避免了传统医疗保健的局限性，例如每次药物剂量调整，饮食和运动建议都需要非常频繁的身体检查。

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