PMID- 19132851
OWN - NLM
STAT- MEDLINE
DCOM- 20090324
LR  - 20220409
IS  - 1520-9156 (Print)
IS  - 1520-9156 (Linking)
VI  - 11
IP  - 1
DP  - 2009 Jan
TI  - Interactive diary for diabetes: A useful and easy-to-use new telemedicine system 
      to support the decision-making process in type 1 diabetes.
PG  - 19-24
LID - 10.1089/dia.2008.0020 [doi]
AB  - BACKGROUND: Widespread use of carbohydrate (CHO) counting is limited by its 
      complex educational needs, but a telemedicine system could simplify the patients' 
      training. METHODS: The Diabetes Interactive Diary (DID) was set up on patients' 
      mobile phones and allowed to record the blood glucose values and quantify the 
      total CHO intake during a meal, by choosing the specific food and the amount 
      ingested from a list of pictures. It also suggested the most appropriate insulin 
      bolus in relation to the patient's CHO/insulin ratio. Data were sent to the 
      physician by Short Message Service (also known as text message). Two pilot 
      studies were carried out to investigate the feasibility and acceptability of the 
      system and its effectiveness in improving metabolic control. RESULTS: In the 
      first study, 50 patients were involved in a survey with questionnaires 
      administered before and 12 weeks after the start of the DID. The system was 
      considered by almost all the patients as easy to use and very helpful. CHO 
      counting and insulin bolus calculation were ranked as the most useful functions. 
      In the second study, 41 consecutive patients using DID under routine clinical 
      practice conditions were evaluated after a median of 9 months of follow-up. DID 
      was associated with a nonstatistically significant reduction in fasting blood 
      glucose (FBG), postprandial glucose (PPG), and hemoglobin A1c levels. FBG and PPG 
      coefficient of variation (CV) values were significantly reduced: FBG-CV decreased 
      by 6.7% (95% confidence interval -11.9, -1.6; P = 0.02), while PPG-CV decreased 
      by 11.5% (95% confidence interval -19.3, -3.7; P = 0.01). No patients reported 
      serious hypoglycemic episodes requiring medical intervention. CONCLUSIONS: DID 
      can represent a useful, safe, and easy-to-use tool to help the patient with type 
      1 diabetes promote dietary freedom. Adjustment of insulin doses according to CHO 
      intake allowed the reduction of glucose variability, increasingly recognized as 
      an important, independent risk factor for cardiovascular events.
FAU - Rossi, Maria C E
AU  - Rossi MC
AD  - Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, 
      S. Maria Imbarco (CH), Italy. mrossi@negrisud.it
FAU - Nicolucci, Antonio
AU  - Nicolucci A
FAU - Pellegrini, Fabio
AU  - Pellegrini F
FAU - Bruttomesso, Daniela
AU  - Bruttomesso D
FAU - Bartolo, Paolo Di
AU  - Bartolo PD
FAU - Marelli, Giuseppe
AU  - Marelli G
FAU - Dal Pos, Michela
AU  - Dal Pos M
FAU - Galetta, Marianna
AU  - Galetta M
FAU - Horwitz, David
AU  - Horwitz D
FAU - Vespasiani, Giacomo
AU  - Vespasiani G
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Diabetes Technol Ther
JT  - Diabetes technology & therapeutics
JID - 100889084
RN  - 0 (Dietary Carbohydrates)
RN  - 0 (Insulin)
SB  - IM
MH  - Adult
MH  - Diabetes Mellitus, Type 1/*drug therapy/psychology/*rehabilitation
MH  - Dietary Carbohydrates
MH  - Female
MH  - Humans
MH  - Insulin/therapeutic use
MH  - Male
MH  - Monitoring, Ambulatory
MH  - Patient Education as Topic
MH  - Self Care
MH  - Surveys and Questionnaires
MH  - *Telemedicine
MH  - Young Adult
EDAT- 2009/01/10 09:00
MHDA- 2009/03/25 09:00
CRDT- 2009/01/10 09:00
PHST- 2009/01/10 09:00 [entrez]
PHST- 2009/01/10 09:00 [pubmed]
PHST- 2009/03/25 09:00 [medline]
AID - 10.1089/dia.2008.0020 [doi]
PST - ppublish
SO  - Diabetes Technol Ther. 2009 Jan;11(1):19-24. doi: 10.1089/dia.2008.0020.