PMID- 23844569 OWN - NLM STAT- MEDLINE DCOM- 20140310 LR - 20221207 IS - 1557-8593 (Electronic) IS - 1520-9156 (Linking) VI - 15 IP - 8 DP - 2013 Aug TI - Impact of the "Diabetes Interactive Diary" telemedicine system on metabolic control, risk of hypoglycemia, and quality of life: a randomized clinical trial in type 1 diabetes. PG - 670-9 LID - 10.1089/dia.2013.0021 [doi] AB - BACKGROUND: Telemedicine systems based on mobile phones represent new promising educational tools. The "Diabetes Interactive Diary" (DID) is a carbohydrate/bolus calculator promoting the patient-physician communication via short message service. This study aimed to compare the efficacy of the DID versus usual care on metabolic control, hypoglycemia, and quality of life. PATIENTS AND METHODS: Patients with type 1 diabetes on a basal:bolus regimen with insulin glargine and insulin glulisine, not previously educated on carbohydrate (CHO) counting, were randomized to DID (Group A; n=63) or traditional education (Group B; n=64). Generalized hierarchical linear regression models for repeated measures were applied to compare changes between groups. Incidence of hypoglycemia was compared using Poisson regression models. RESULTS: Of 127 patients (age, 36.9+/-10.5 years; diabetes duration, 16.3+/-9.3 years), 15 (11.8%) dropped out. After 6 months, hemoglobin A1c (HbA1c) levels decreased by -0.49+/-0.11 in Group A and -0.48+/-0.11 in Group B (P=0.73). Group A showed a 86% lower risk of grade 2 hypoglycemia than Group B. Compared with usual care, DID improved the "perceived frequency of hyperglycemic episodes" scale of the Diabetes Treatment Satisfaction Questionnaire and the "social relations" and the "fear of hypoglycemia" dimensions of the Diabetes Specific Quality of Life Scale. Results obtained with DID markedly differ among patients and centers. CONCLUSIONS: DID is no more effective than traditional CHO counting education in reducing HbA1c levels. DID reduces the risk of moderate/severe hypoglycemia and improves quality of life. A better understanding of patients' and healthcare professionals' attitudes associated with an effective care supported by technology is essential to avoid waste of resources. FAU - Rossi, Maria Chiara AU - Rossi MC AD - Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, S. Maria Imbaro, Chieti, Italy. mrossi@negrisud.it FAU - Nicolucci, Antonio AU - Nicolucci A FAU - Lucisano, Giuseppe AU - Lucisano G FAU - Pellegrini, Fabio AU - Pellegrini F FAU - Di Bartolo, Paolo AU - Di Bartolo P FAU - Miselli, Valerio AU - Miselli V FAU - Anichini, Roberto AU - Anichini R FAU - Vespasiani, Giacomo AU - Vespasiani G CN - Did Study Group LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20130711 PL - United States TA - Diabetes Technol Ther JT - Diabetes technology & therapeutics JID - 100889084 RN - 0 (Glycated Hemoglobin A) RN - 0 (Hypoglycemic Agents) RN - 0 (hemoglobin A1c protein, human) SB - IM MH - Adult MH - Combined Modality Therapy/adverse effects MH - Diabetes Mellitus, Type 1/blood/*diet therapy/*drug therapy MH - Diet Records MH - Drug Therapy, Combination/adverse effects MH - Female MH - Glycated Hemoglobin/analysis MH - Humans MH - Hyperglycemia/*prevention & control MH - Hypoglycemia/epidemiology/*prevention & control MH - Hypoglycemic Agents/administration & dosage/adverse effects/therapeutic use MH - Intention to Treat Analysis MH - Italy/epidemiology MH - Male MH - Middle Aged MH - Patient Dropouts MH - Patient Satisfaction MH - *Quality of Life MH - Risk MH - Telemedicine/*methods FIR - Vespasiani, Giacomo IR - Vespasiani G FIR - del Tronto, S Benedetto IR - del Tronto S FIR - Nicolucci, Antonio IR - Nicolucci A FIR - Sud, Consorzio Mario Negri IR - Sud CM FIR - Imbaro, S Maria IR - Imbaro S FIR - Di Bartolo, Paolo IR - Di Bartolo P FIR - Miselli, Valerio IR - Miselli V FIR - Rabitti, Elisa IR - Rabitti E FIR - Valenti, Susanna IR - Valenti S FIR - Accorsi, Paola IR - Accorsi P FIR - Dotti, Cristina IR - Dotti C FIR - Anichini, Roberto IR - Anichini R FIR - Tedeschi, Laura IR - Tedeschi L FIR - Di Bartolo, Paolo IR - Di Bartolo P FIR - Sardu, Cipriana IR - Sardu C FIR - Pellicano, Francesca IR - Pellicano F FIR - Brandolini, Sara IR - Brandolini S FIR - Scolozzi, Patrizia IR - Scolozzi P FIR - Suraci, Concetta IR - Suraci C FIR - Abbruzzese, Santina IR - Abbruzzese S FIR - Leotta, Sergio IR - Leotta S FIR - Fontana, Lucia IR - Fontana L FIR - Carletti, Silvia IR - Carletti S FIR - Altomare, Maria IR - Altomare M FIR - Galimberti, Gabriella IR - Galimberti G FIR - Laurenzi, Andrea IR - Laurenzi A FIR - Trojani, Cristina IR - Trojani C FIR - Bruglia, Matteo IR - Bruglia M FIR - Sciangula, Luigi IR - Sciangula L FIR - Ciucci, Alessandra IR - Ciucci A FIR - Bellini, Elisa IR - Bellini E FIR - Tono, Adele IR - Tono A FIR - Comense, Mariano IR - Comense M FIR - Acquati, Silvia IR - Acquati S FIR - Pierantoni, L IR - Pierantoni L FIR - Bonomo, Andrea Matteo IR - Bonomo AM FIR - Meneghini, Elena IR - Meneghini E FIR - Del Prato, Stefano IR - Del Prato S FIR - Bertolotto, Alessandra IR - Bertolotto A FIR - Aragona, Michele IR - Aragona M FIR - Grassi, Giorgio IR - Grassi G FIR - Tomelini, Michela IR - Tomelini M FIR - Battista, Giovanni IR - Battista G FIR - Rossi, Mauro IR - Rossi M FIR - Nicolucci, Antonio IR - Nicolucci A FIR - Rossi, Maria Chiara IR - Rossi MC FIR - Lucisano, Giuseppe IR - Lucisano G FIR - Pellegrini, Fabio IR - Pellegrini F FIR - Valentini, Miriam IR - Valentini M FIR - Pirozzoli, Celeste IR - Pirozzoli C FIR - D'Alonzo, Daniela IR - D'Alonzo D FIR - Memmo, Riccarda IR - Memmo R FIR - Di Nardo, Barbara IR - Di Nardo B FIR - Imbaro, S Maria IR - Imbaro S EDAT- 2013/07/13 06:00 MHDA- 2014/03/13 06:00 CRDT- 2013/07/13 06:00 PHST- 2013/07/13 06:00 [entrez] PHST- 2013/07/13 06:00 [pubmed] PHST- 2014/03/13 06:00 [medline] AID - 10.1089/dia.2013.0021 [doi] PST - ppublish SO - Diabetes Technol Ther. 2013 Aug;15(8):670-9. doi: 10.1089/dia.2013.0021. Epub 2013 Jul 11.