OBJECTIVE -The Internet is used worldwide as a communication tool. To improve the quality of diabetes control, we investigated the effectiveness of an Internet-based blood glucose monitoring system (IBGMS) on controlling the changes in HbA 1c levels.RESEARCH DESIGN AND METHODS -We conducted a randomized clinical trial involving 110 patients who visited the outpatient clinic at the Kangnam St. Mary's Hospital for 3 months. The study subjects were treated with IBGMS for 12 weeks, and the control group received the usual outpatient management over the same period. HbA 1c and other laboratory tests were performed twice, once at the beginning of the study and again at the end of the study.RESULTS -The test results from the beginning of the study established that there were no significant differences between the two groups with respect to age, sex, diabetes duration, BMI, blood pressure, HbA 1c , and other laboratory data. On follow-up examination 12 weeks later, HbA 1c levels were significantly decreased from 7.59 to 6.94% within the intervention group (P Ͻ 0.001). At the end of the study, HbA 1c levels in the intervention group were significantly lower than in the control group after adjusting the baseline HbA 1c (6.94 vs. 7.62%; P Ͻ 0.001, respectively). Among patients with baseline HbA 1c Ͻ7.0%, the patients in the intervention group had lower HbA 1c than those in the control group (6.38 vs. 6.99%; P Ͻ 0.05). Among the patients with a baseline HbA 1c Ն7.0%, the difference between the two groups appeared more obvious: HbA 1c levels at the end of the study were 8.12%.CONCLUSIONS -This new IBGMS resulted in a significant reduction of HbA 1c during the study period. We propose that this IBGMS be used as a method for improving diabetes control. Diabetes Care 27:478 -483, 2004T he importance of tight blood glucose control for the subsequent prevention of diabetes complication is well established (1,2). In addition, improving glucose control will also reduce the enormous economic burden associated with the disease (3,4). Therefore, various strategies for diabetes management have been designed to improve the quality and efficiency of care for patients with diabetes. To promote adherence for patients and providers to follow practical guidelines, studies have been carried out to establish educational programs for patients and health care workers. Other studies, including giving feedback to the providers as well as programs that remind providers and their patients of these guidelines, have been experimented with (5-8). Recently, a small number of computer-based or electronic management systems have been reported to improve diabetes care (9 -11). However, many barriers are recognized in providing this care system into the community health care system (12,13). Diabetes care means managing vulnerable patients with chronic disease consistently in the outpatient setting. Chin et al. (13) reported that providers in health care centers indicated a need to enhance behavioral changes in diabetic patients to improve the health care de...

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On the basis of clinical and electrophysiological findings, focal demyelination of motor branches of the trigeminal nerve owing to deep tissue changes is suggested as the cause of abnormal excitatory electrical activities resulting in involuntary masticatory movement.