What We Can Really Expect from Telemedicine in Intensive Diabetes Treatment: 10 Years Later

Abstract

During the last 10 years many new telematic systems aiming at support of diabetes treatment have been designed and developed. Most systems that were applied in clinical randomized trials used the classical approach, with data transfers from patients performed usually once every few days. In the few available meta-analyses of these trials, a significant improvement of the mean hemoglobin A1c was demonstrated in patients using telematic systems. However, the magnitude of this improvement in comparison with the control groups was lower than expected. This conclusion was confirmed by results of the IDEATel study involving more than 1,600 patients over a period of 5 years. It might by hypothesized that in some groups of patients continuous telecare with frequent contacts between patients and the care provider during each day should be required. This hypothesis is confirmed by the results of the clinical trials applying real-time diabetes monitoring systems. However, the increased frequency of the data transfers and checkups requires a new model for technology-supported care. The new model should connect together the ubiquitous data transfer with an automatically selected optimal frequency, the automatic assessment of the data coupled with quicker feedback from the decision support system or from the provider, and selection of the optimal time for the patient's face-to-face visit in the clinic. All this new future implementations together with already confirmed advantages of the telematic support, such as the increase of self-confidence of the patient, will hopefully give real benefits for the patients.

Telemedicine and eHealth in Poland from 1995 to 2015

“…14,20,[25][26][27] Specialists in family medicine, primary care and internal medicine usually implement home telemonitoring of chronic diseases and blood pressure monitoring in their studies, and there are a few research groups focused on telediabetology. 28,29 Telepathology was introduced in the 1990s in Poznań with the description of remote automatic microscope functionality, and several more papers focused on additional telepathology applications. 23,24,[30][31][32] We observed a significant impact of research focusing on otorhinolaryngology ("ear, nose and throat" or ENT), especially with using telemedicine for cochlear implant fitting.…”

Telemedicine in US Army soldiers with type 1 diabetes

“…Several recent reviews have shown that telemedicine has some success in treating patients with type 1 diabetes. 5–11 However, randomized controlled trials are not available to show the efficacy of using telemedicine to treat patients with diabetes who have a lifestyle comparable to a soldier. There are case reports of athletes with type 1 diabetes who have been monitored during endurance sports, 12–15 some with continuous glucose monitoring.…”

Ökonomische Potentiale der Delegation mit und ohne Telemedizin bei Menschen mit Diabetes Mellitus – Ergebnisse einer Subgruppenanalyse eines Scoping Reviews

“…Separate Kosteneinsparungen durch die Digitalisierung in Form von telemedizinischen Innovationen zeigen sich in dieser Arbeit nicht. Sie werden jedoch in der Literatur mehrfach beschrieben [41,42].…”