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A Telemedicine System Intervention for Patients With Type 1 Diabetes: Pilot Feasibility Crossover Intervention Study

JMIR Formative Research · 9 authors, 7 centres

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TL;DR

This pilot study evaluated the Diani telemedicine system in 10 adults with type 1 diabetes over 24 weeks. The central finding was a significant decrease in HbA1c levels after intervention.

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This was a 24-week pilot feasibility study evaluating the Diani telemedicine system in 10 patients with type 1 diabetes. The system gathered data on blood glucose, insulin, diet, and activity, providing graphical feedback to patients. Analysis showed a statistically significant mean decrease in HbA1c of 4.35 mmol/mol after intervention (P=.01). Patients spent an average of 18.6 minutes daily using the app, and the system was positively evaluated for usability and motivating patients. The study also noted an increase in self-monitored blood glucose frequency. Key limitations include the small sample size (10 patients), recruitment challenges, technical issues with data transfer, and low return rate on some questionnaires limiting reliability of quality-of-life findings. The study demonstrates the system's feasibility and potential short-term benefit for glycemic control and patient engagement.

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other

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endocrinology

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100% · A

ORIGINAL PAPER

PMC10182449

A Telemedicine System Intervention for Patients With Type 1 Diabetes: Pilot Feasibility Crossover Intervention Study

JMIR Formative Research

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ABSTRACT

Abstract Background Today’s diabetes-oriented telemedicine systems can gather and analyze many parameters like blood glucose levels, carbohydrate intake, insulin doses, and physical activity levels (steps). Information collected can be presented to patients in a variety of graphical outputs. Despite the availability of several technical means, a large percentage of patients do not reach the goals established in their diabetes treatment. Objective The objective of the study was to evaluate the benefits of the Diani telemedicine system for the treatment of patients with type 1 diabetes mellitus. Methods Data were collected during a 24-week feasibility study. Patients responded to the World Health Organization Quality of Life – BREF (WHOQOL-BREF) questionnaire and a system evaluation questionnaire. The level of glycated hemoglobin (HbA 1c ) and the patient’s body weight were measured, and the patient’s use of the telemedicine system and their daily physical activity level were monitored. All data were sent from the patient’s device to the Diani server using a real-time diabetes diary app. Wilcoxon and Friedman tests and the linear mixed effects method were used for data analysis. Results This study involved 10 patients (men: n=5; women: n=5), with a mean age of 47.7 (SD 19.3) years, a mean duration of diabetes of 10.5 (SD 8.6) years, and a mean HbA 1c value of 59.5 (SD 6.7) mmol/mol. The median number of days the patients used the system was 84. After the intervention, the mean HbA 1c decreased by 4.35 mmol/mol ( P =.01). The patients spent 18.6 (SD 6.8) minutes on average using the app daily. After the intervention, the number of patients who measured their blood glucose level at least 3 times a day increased by 30%. The graphical visualization of the monitored parameters, automatic transmission of measured data from the glucometer, compatibility, and interconnection of individual devices when entering data were positively evaluated by patients. Conclusions The Diani system was found to be beneficial for patients with type 1 diabetes mellitus in terms of managing their disease. Patients perceived it positively; it strengthened their knowledge of diabetes and their understanding of the influences of the measured values on the management of their disease. Its use had a positive effect on the HbA 1c level. Keywords: diabetes mellitus, diabetes, telemedicine, telemedicine system, mobile health, mHealth, telemonitoring, quality of life, telehealth, compensation, evaluation, intervention, feasibility

CITATION EXPORT

Martina Vlasakova, Jan Muzik, Anna Holubová et al.. A Telemedicine System Intervention for Patients With Type 1 Diabetes: Pilot Feasibility Crossover Intervention Study. JMIR Formative Research. (2023). https://doi.org/10.2196/35064

AUTHORS

9 · 7 CENTRES

Martina Vlasakova, Jan Muzik, Anna Holubová, Dominik Fiala, Eirik Arsand, Jana Urbanová, Denisa Janíčková Žďárská, Marek Brabec, Jan Brož

1First Faculty of Medicine, Charles University, Prague, Czech Republic
2Department of Information and Communication Technologies in Medicine, Faculty of Biomedical Engineering, Czech Technical University in Prague, Praha, Czech Republic
3University of Tromsø – The Arctic University of Norway, Tromsø, Norway
4Norwegian Centre for E-health Research, Tromsø, Norway
5Department of Internal Medicine, Faculty Hospital Kralovske Vinohrady, Center for Research in Diabetes, Metabolism and Nutrition, Charles University Third Faculty of Medicine, Prague, Czech Republic
6Department of Internal Medicine, Second Medical Faculty, Charles University and Motol University Hospital, Prague, Czech Republic
7Institute of Computer Science, Academy of Science of the Czech Republic, Prague, Czech Republic