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Cho, Kwon, and Yoon: Perspectives of "Ubiquitous Health Care System" for Diabetes Management
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The Journal of Korean Diabetes Association

The Journal of Korean Diabetes Association 2006; 30(2): 87-95.

Published online: 31 March 2006

DOI: https://doi.org/10.4093/jkda.2006.30.2.87

Perspectives of "Ubiquitous Health Care System" for Diabetes Management

Jae-Hyoung Cho, Hyuk-Sang Kwon, Kun-Ho Yoon

Department of Endocrinology and Metabolism, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Copyright © 2006 Korean Diabetes Association

Abstract

Although clear evidences of the beneficial effects of tight glycemic control on diabetic patients had been already made, the past decade has not seen any noticeable improvement in terms of glycemic control. "Ubiquitous health care system", which is one of the developing fusion technologies of IT, BT and NT, could give us new solutions in future. We established the Internet based glucose monitoring system (IBGMS) and conducted prospective, randomized short-term and long-term clinical trials using the system which can guide the patients with diabetes by mobile technology anytime and anywhere. The mean HbA1c and HbA1c fluctuation index (SD of mean HbA1c) during the whole study period was significantly lowered by the intervention, suggesting more improved state in both HbA1c level and glucose stability. Appropriate physician's advises to the patients' questions and problems at the right time through the IBGMS were the major interventions. Although many unsolved problems still exist, the Internet-based bidirectional communication system developed by the advanced information technology can contribute to the foundations to tomorrow's or ubiquitous medicine.

Keywords: HbA1c, Internet, Ubiquitous

ACKNOWLEDGEMENT

We would like to express gratitude to the software programmer, Young-Hwan Pack, the diabetic nurse Bok-Ryoe Song. This work was supported by Korea Research Foundation Grant (KRF-2004-041-E00148).

References

1. The Diabetes Control and Complications Trial Research Group. Effect of intensive diabetes management on macrovascular events and risk factors in the Diabetes Control and Complications Trial. Am J Cardiol. 1995. 75:894–903.
2. Writing Team for the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Research Group. Effect of intensive therapy on the microvascular complications of type 1 diabetes mellitus. JAMA. 2002. 287:2563–2569.
3. UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. UK Prospective Diabetes Study Group. BMJ. 1998. 317:703–713.
4. Ohkubo Y, Kishikawa H, Araki E, et al. Intensive insulin therapy prevents the progression of diabetic microvascular complications in Japanese patients with non-insulin-dependent diabetes mellitus: a randomized prospective 6-year study. Diabetes Res Clin Pract. 1995. 28:103–117.
5. Saydah SH, Fradkin J, Cowie CC. Poor control of risk factors for vascular disease among adults with previously diagnosed diabetes. JAMA. 2004. 291:335–342.
6. Koro CE, Bowlin SJ, Bourgeois N, Fedder DO. Glycemic control from 1988 to 2000 among U.S. adults diagnosed with type 2 diabetes: a preliminary report. Diabetes Care. 2004. 27:17–20.
7. Ubink-Veltmaat LJ, Bilo HJ, Groenier KH, et al. Prevalence, incidence and mortality of type 2 diabetes mellitus revisited: a prospective population-based study in The Netherlands (ZODIAC-1). Eur J Epidemiol. 2003. 18:793–800.
8. Gatling W, Budd S, Walters D, et al. Evidence of an increasing prevalence of diagnosed diabetes mellitus in the Poole area from 1983 to 1996. Diabet Med. 1998. 15:1015–1021.
9. Berger B, Stenstrom G, Sundkvist G. Incidence, prevalence, and mortality of diabetes in a large population. A report from the Skaraborg Diabetes Registry. Diabetes Care. 1999. 22:773–778.
10. Boyle JP, Honeycutt AA, Narayan KMV, et al. Projection of diabetes burden through 2050. Diabetes Care. 2001. 24:1936–1940.
11. King H, Aubert RE, Herman WH. Global burden of diabetes, 1995-2025: prevalence, numerical estimates, and projections. Diabetes Care. 1998. 21:1414–1431.
12. Dunstan DW, Zimmet PZ, Welborn TA, et al. The rising prevalence of diabetes and impaired glucose toleranc: the Australian diabetes, obesity and lifestyle study. Diabetes Care. 2002. 25:829–834.
15. Kwon HS, Cho JH, Kim HS, Lee JH, Song BR, Oh JA, Han JH, Kim HS, Cha BY, Lee KW, Son HY, Kang SK, Lee WC, Yoon KH. Development of web-based diabetic patient management system using short message service. Diabetes Res Clin Pract. 2004. 66:Suppl. S133–S137.
16. Kwon HS, Cho JH, Kim HS, Song BR, Ko SH, Lee JM, Kim SR, Chang SA, Kim HS, Cha BY, Lee KW, Son HY, Lee JH, Lee WC, Yoon KH. Establishment of blood glucose monitoring system using the internet. Diabetes Care. 2004. 27:478–483.
17. Farmer AJ, Gibson OJ, Dudley C, Bryden K, Hayton PM, Tarassenko L, Neil A. A Randomized Controlled Trial of the Effect of Real-Time Telemedicine Support on Glycemic Control in Young Adults With Type 1 Diabetes. Diabetes Care. 2005. 28:2697–2702.
18. Caro JJ, Ward AJ, O'Brien JA. Lifetime costs of complications resulting from type 2 diabetes in the U.S. Diabetes Care. 2002. 25:476–481.
19. American Diabetes Association. Economic consequences of diabetes mellitus in the U.S. in 1997. Diabetes Care. 1998. 21:296–309.
20. Starren J, Hripcsak G, Sengupta S, Abbruscato CR, Knudson PE, Weinstock RS, Shea S. Columbia University's Informatics for Diabetes Education and Telemedicine (IDEATel) project: technical implementation. J Am Med Inform Assoc. 2002. 9:25–36.
21. Shea S, Starren J, Weinstock RS, Knudson PE, Teresi J, Holmes D, Palmas W, Field L, Goland R, Tuck C, Hripcsak G, Capps L, Liss D. Columbia University's Informatics for Diabetes Education and Telemedicine (IDEATel) Project: rationale and design. J Am Med Inform Assoc. 2002. 9:49–62.
22. Gomez E, del Pozo F, Hernando E. Telemedicine for diabetes care: the DIABTel approach towards diabetes telecare. Med Inf. 1996. 21:283–295.
23. Bellazzi R, Cobelli C, Gomez E, Stefanelli M. Bracale M, Denoth F, editors. The T-IDDM project: Telematic management of Insulin Dependent Diabetes Mellitus. Proceedings HT-95. 1995. Ischia: 271–276.
24. Fallucca F, Di Biase N, Sabbatini A, Borrello E, Sciullo E, Napoli A. Telemedicine in the treatment of diabetic pregnancy. Pract. Diab. Intl. 1996. 13:115–118.
25. Rosenfalck A.M., Bendtson I. The Diva System, a computerized diary, used in young type 1 diabetic patients. Diabete Metab. 1993. 19:25–29.
26. Albisser A.M, Harris RH, Sakkal S, Parson ID, Chao SCE. Diabetes intervention in the information age. Med Inf. 1996. 21:297–316.
27. Lehmann ED, Deutsch T, Broad D. AIDA: an educational simulator for insulin dosage and dietary adjustment in diabetes. 1996. Available from: http://www.2aida.org.
28. Levetan CS, Dawn KR, Robbins DC, Ratner RE. Impact of computer-generated personalized goals on HbA1c. Diabetes Care. 2002. 25:2–8.
29. Lobach DF, Hammond WE. Computerized decision support based on a clinical practice guideline improves compliance with care standards. Am J Med. 1997. 102:89–98.
30. Meigs JB, Cagliero E, Eubery A, et al. A controlled trial of web-based diabetes disease management; the MGH Diabetes Primary Care Improvement Project. Diabetes Care. 2003. 26:750–757.
31. Smith SA, Murphy ME, Huschka TR, et al. Impact of a diabetes electronic management system on the care of patients seen in a subspecialty diabetes clinic. Diabetes Care. 1998. 21:972–976.
32. Meneghini LF, Goldberg RB, Albisser AM, Mintz DH. An electronic manager for diabetes control. Diabetes Care. 1998. 21:591–596.
33. Frost D, Beischer W. Telemedicine in the management of pregnancy in type 1 diabetic women. Diabetes Care. 2000. 23:863–864.
34. Feil EG, Glasgow RE, Boles S, McKay HG. Who participate in Internet-based self-management programs: a study among novice computer users in a primary care setting. Diabetes Educ. 2000. 26:806–811.
35. Mckay HG, King D, Eakin EG, Seeley JR, Glasgow RE. The diabetes network Internet-based physical activity intervention. Diabetes Care. 2001. 24:1328–1334.
36. Glasgow RE, McKay HG, Boles SM, Vogt TM. Interactive technology, behavioral science, and family practice. J Fam Pract. 1999. 48:464–470.
37. Castaldini M, Saltmarch M, Luck S, Sucher K. The development and pilot testing of a multimedia CD-ROM for diabetes education. Diabetes Educ. 1998. 24:285–286.
38. Tomky DM. Developing a computerized diabetes self-management education module for documenting outcomes. Diabetes Educ. 1999. 25:197–210.
39. McMahon GT, Gomes HE, Hohne SH, Hu TMJ, Levine BA, Conlin PR. Web-Based Care Management in Patients With Poorly Controlled Diabetes. Diabetes Care. 2005. 28:1624–1629.
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