Journal List > Korean Diabetes J > v.33(3) > 1002294

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Lee, Jeong, Kim, Park, Kim, Seo, Kim, Kim, Choi, Baik, and Choi: The Effect of Cellular Phone-Based Telemedicine on Glycemic Control in Type 2 Diabetes Patients Using Insulin Therapy
Original Article
Korean Diabetes Journal

Korean Diabetes Journal 2009; 33(3): 232-240.

Published online: 30 June 2009

DOI: https://doi.org/10.4093/kdj.2009.33.3.232

The Effect of Cellular Phone-Based Telemedicine on Glycemic Control in Type 2 Diabetes Patients Using Insulin Therapy

Yun Jeong Lee1, Mi Hyun Jeong2, Joo Hyung Kim1, Juri Park1, Hee Young Kim1, Ji A Seo1, Sin Gon Kim1, Nan Hee Kim1, Kyung Mook Choi1, Sei Hyun Baik1, Dong Seop Choi1

1Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.

2Diabetes Center, Korea University Anam Hospital, Seoul, Korea.

Corresponding author (cdongs@kumc.or.kr)

Received 14 April 2009       Accepted 1 June 2009

Copyright © 2009 Korean Diabetes Association

Abstract

Background

Cellular phones are extremely prevalent in modern society and they enable appropriate feedback mechanisms through real time monitoring and short message services regarding blood glucose levels. We investigated whether cellular phone-based telemedicine support system could improve blood glucose control in type 2 diabetes patients who were in inadequate glycemic control regardless of insulin therapy.

Methods

A randomized, controlled clinical trial was conducted involving 74 type 2 diabetic patients with suboptimal glycemic control (HbA1c levels > 7%) regardless of insulin therapy. The intervention (cellular phone-based telemedicine) group managed their blood glucose using a cellular phone for 3 months, while the control (self monitoring of blood glucose) group managed their blood glucose with a standard glucometer for the same period.

Results

Three months later, HbA1c levels were decreased in both groups. However, the decrease in the control group from 8.37% to 8.20% was only 0.20% (P = 0.152) which was not significant. In contrast, the intervention group had a significant reduction of 0.61% from 8.77% to 8.16% (P < 0.001). Moreover, among patients with a baseline ≥ 8%, the patients in the intervention group showed a significant reduction of 0.81% from 9.16% to 8.34% (P < 0.001).

Conclusion

HbA1c levels were significantly decreased in the cellular phone-based telemedicine group compared with the control group after 3 months. This study suggests that cellular phone-based telemedicine is helpful for better glucose control in type 2 diabetes patients who previously were unable to control glucose levels adequately with insulin therapy.

Keywords: Cellular phone, Diabetes mellitus, Telemedicine

Figures and Tables

Table 1
Baseline clinical and biochemical laboratory data of subjects
kdj-33-232-i001

Data are n (%) or means ± SD or median (25%~75%). *Chi-square test. †Independent student t-test. ‡Non-parametric method, Wilcoxon's rank sum test. ALT, alanine aminotransferase; AST, aspartate amino-transferase; BMI, body mass index; DBP, diastolic blood pressure; FBS, fasting blood sugar; HDL-cholesterol, high-density lipoprotein cholesterol; PP2hr, post prandial 2 hour blood sugar; SBP, systolic blood pressure.

Table 2
Treatment of modalities of subjects at baseline
kdj-33-232-i002

Data are n (%) or means ± SD. *Chi-square test and Fisher's exact test. †Independent student t-test. NPH, neutral protamine Hagedorn; OHAs, oral hypoglycemic agents; RI, regular insulin.

Table 3
Change of the laboratory data and differences between intervention and control group
kdj-33-232-i003

Data are n (%) or means ± SD or median (25%~75%). *Independent student t-test. †ANCOVA (adjusted for age, BMI, creatinine, insulin injection time, insulin dosage). FBS, fasting blood sugar; HDL-cholesterol, high-density lipoprotein cholesterol; PP2 hr, post-prandial 2 hour.

Table 4
Change of HbA1c according to baseline HbA1c in two group
kdj-33-232-i004

Data are means ± SD. *Independent student t-test.

Table 5
Satisfaction measurement of intervention group
kdj-33-232-i005

Data are n (%); Perfect score of each point is 5.0. *Chi-square test and Fisher's exact test; question 1, providing information of educator; question 2, handy convenience; question 3, general management; question 4, automatic glucose recording system; question 5, degree of interest question 6, conveniencec of program.

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