A new study finds that a remote telemonitoring system enabling patients to send regular glucose readings to health care professionals was helpful for individuals with poorly controlled type 2 diabetes.
In 2013, the International Diabetes Federation estimated that roughly 206 million people around the world have been diagnosed with diabetes. This common condition requires patients to monitor their diet and blood sugar levels on a daily basis. Over the long-term, poor blood sugar management can lead to serious complications such as heart and kidney disease, retinal damage and circulatory problems.
Health care systems around the world are feeling the impact of increased health care needs associated with patients who have type 2 diabetes. Costs for diabetes patients are estimated to be two to three times higher than for non-diabetic patients of similar age and sex; in developed countries, roughly 80% of those costs are attributable to complications of the disease. Thus, there are strong incentives, both for individuals and societies as a whole, to establish effective practices for blood sugar monitoring.
Past experience suggests that the traditional model for monitoring of patients with diabetes has some drawbacks. The model requires patients to self-monitoring (i.e., track blood sugar levels on their own), and attend infrequent consultations with their physician. For many patients, this approach has proven to be ineffective in long-term management of the disease, possibly because of factors like poor adherence to dietary or medication regimes, failure of patients to consult their doctor despite unstable symptoms, and therapeutic inertia on the part of physicians.
However, a new study published by PLOS Medicine suggests a different approach that may provide better results. The 9-month study involved 321 patients with type 2 diabetes selected from family practices across the UK, who had been identified as having poor control over their blood sugar levels. Patients were divided into two groups: a control group, who were followed in the usual way by their family physician, and a second group (the monitored group) who used blood pressure, blood sugar, and weight monitors equipped with Bluetooth technology to transmit readings to a remote server, where they were followed by research nurses. The nurses were asked to check results on the server once per week and to contact the patients by phone to recommend treatment changes as needed, based on national guidelines for management of diabetes and hypertension.
At the end of the nine months, patients in both groups were found to have lower blood sugar levels on average than prior to the study. However, the change in blood sugar was more pronounced in the monitored group than the control group. In addition, the monitored group also showed a decrease in blood pressure, whereas no similar change occurred in the control group. No significant change in weight occurred in either group.
Based on these results, authors of the study suggest that a remote monitoring system providing for more frequent input from health care practitioners could be helpful for improving glycemic management in patients with previously poor control over blood sugar levels. They note that such a system also requires relatively minimal additional time from health professionals, and therefore may be an attractive option with long-term benefits for both cost and patient outcomes.
Written By: Linda Jensen