Background Despite the fact there are many wearable and mobile medical devices that enable patients to better self-manage their diabetes, not many patients are aware of all the options they have. In addition, there are those who are not fully satisfied with the devices they use, and those who often do not use them effectively. Objective The study aimed to propose possible changes to the combination of devices used by 6 specific patients for diabetes self-management. We assessed the suitability of selected technical devices for diabetes control. Methods Data of 6 patients (3 men and 3 women) with type 1 diabetes mellitus, who had been using the Diani telemedicine system for at least 3 months, were analyzed. The suitability of selected technical devices for diabetes control was ascertained using the data obtained via the Diani telemedicine system, as well as the patients’ subjective feelings and statements, their everyday life habits, and self-management of diabetes. Informed consent was signed and obtained from each of the patients included. Results Each of the presented case studies describes how a given patient handled the system and its specific components based on his or her lifestyle, level of education, habits related to diabetes management, personality type, and other factors. At the conclusion of each case study, the best composition of devices for patients with similar personal descriptions was suggested. Conclusions We believe this study can provide relevant guidance on how to help particular patients choose the technology that is best suited for their needs, based on the specific patient information we are able to obtain from them. Furthermore, clinicians or educators should be aware of available technologies a given patient can choose from. In addition, there is a substantial need for proper patient education in order for them to effectively use devices for diabetes self-management.
interní klinika 3. LF UK a FNKV Praha Mobilní a nositelná elektronika nabízí pacientům s diabetes mellitus nové možnosti sběru dat a jejich efektivnější analýzu. Aplikace pro chytré telefony Diabetesdagboka a webový portál Diani umožňují shromažďování a analýzu hodnot glykemie, dávek sacharidů a inzulinu a míry pohybové aktivity. Hodnoty jsou dostupné v příslušném mobilním telefonu, ale jsou též automatizovaně přenášeny do internetového portálu, kde mohou být doplněny o záznam z elektronického krokoměru a kontinuálního monitoru glykemie. Lze je též zobrazit v různých typech grafických výstupů a jsou dostupné nejenom pacientovi, ale i jeho lékaři. Kazuistika pacienta, který systém téměř 2 roky využíval, prokazuje významné zlepšení metabolické kompenzace (pokles průměrné hodnoty HbA1c o 18,6 mmol/mol v porovnání s předchozím obdobím).Klíčová slova: diabetes mellitus, diabetický deník, HbA 1c , hypoglykemie, mobilní aplikace, telemedicína, telemonitoring, webové aplikace, webový portál.Long term use of the telemonitoring system Diani in the therapy of a patient with type 1 diabetes Mobile and wearable technologies offer patients with diabetes mellitus new possibilities for data collection and their more effective analysis. The Diabesdagboga smartphone application and the Diani web portal enable to collect and analyze glycaemia values, carbohydrates intake, insulin doses and the level of physical activity. The data are not only accessible in the corresponding smartphone but also automatically transferred to an Internet portal, where they may be completed by the records from an electronic pedometer and continuous glucose monitor. All these data may then be displayed in various types of graphical outputs and are available to both the patient and the physician. The case report of a patient who has used the system for almost two years shows a significant improvement in metabolic compensation (a decrease in the mean HbA1c value by 18.6 mmol/mol as compared with the previous period).
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 (HbA1c) 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 HbA1c 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 HbA1c 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 HbA1c level.
BACKGROUND Telemedicine systems have been proven to be a successful tool for the supporting patients in diabetes mellitus selfmanagement. Despite this, a large percentage of patients do not use of all available functions of telemedicine systems. And this is one of the reasons, why patients do not meet the target compensation of their disease. This paper presents the current features of the Diani telemedicine system and the evaluation outcomes of its use. Dani has been designed to provide the patients with a comprehensive overview of their collected data including carbohydrate intake, insulin doses, physical activity level (steps) and blood glucose. OBJECTIVE The objective of the study was to evaluate the benefits of the Diani telemedicine system for the treatment of type 1 diabetes patient. The obtained suggestions will lead to further verification and development of the system in order to better compensate for diabetes mellitus. METHODS Data were obtained on the basis of a 24-week, randomized, crossover, intervention study. Patients responded to the standardized WHOQOL-BREF quality of life questionnaire and the system evaluation questionnaire. Both the level of glycated hemoglobin and the patient's weight were examined. The patient's usage of the telemedicine system was monitored and daily physical activity was measured. All data were being sent from the device to the Diani server using a real-time diabetic diary application. Wilcoxon and Friedman tests and LME method were used for data analysis. This study involved 10 patients (5 men and 5 women) who participated in the Diani system evaluation. The mean age of the participants was 47.7 ± 19.3 years; the mean duration of diabetes was 10.5 ± 8.6 years; and the mean HbA1c was 59.5 ± 6.7 mmol/mol. RESULTS The median number of days during which the patients tested the system was 84. After the intervention the mean HbA1c decreased by 4.35 mmol/mol (p = 0.011). Patients spent 18.6 ± 6.8 minutes on average using the application daily. After the Diani system intervention, the number of patients who measured their blood glucose at least 3 times a day increased by 30%. The graphical display of measured quantities, automatic transmission of measured data from the glucometer, compatibility and interconnection of individual devices when entering data were evaluated by patients in a positive way. CONCLUSIONS Diani system is beneficial for type 1 diabetes mellitus patients in terms of controlling their disease. Patients perceive it positively; it strengthens their education in the field of diabetes and understanding the influence of measured values on the compensation of their disease. Its use has a positive effect on the HbA1C level.
BACKGROUND Despite the fact there are many wearable and mobile medical devices that enable patients to better self-manage their diabetes, not many patients are aware of all the options they have. In addition, there are those who are not fully satisfied with the devices they use, and those who often do not use them effectively. OBJECTIVE The study aimed to propose possible changes to the combination of devices used by 6 specific patients for diabetes self-management. We assessed the suitability of selected technical devices for diabetes control. METHODS Data of 6 patients (3 men and 3 women) with type 1 diabetes mellitus, who had been using the Diani telemedicine system for at least 3 months, were analyzed. The suitability of selected technical devices for diabetes control was ascertained using the data obtained via the Diani telemedicine system, as well as the patients’ subjective feelings and statements, their everyday life habits, and self-management of diabetes. Informed consent was signed and obtained from each of the patients included. RESULTS Each of the presented case studies describes how a given patient handled the system and its specific components based on his or her lifestyle, level of education, habits related to diabetes management, personality type, and other factors. At the conclusion of each case study, the best composition of devices for patients with similar personal descriptions was suggested. CONCLUSIONS We believe this study can provide relevant guidance on how to help particular patients choose the technology that is best suited for their needs, based on the specific patient information we are able to obtain from them. Furthermore, clinicians or educators should be aware of available technologies a given patient can choose from. In addition, there is a substantial need for proper patient education in order for them to effectively use devices for diabetes self-management.
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