Telemedical care reduces hypoglycemias and improves glycemic control in children and adolescents with type 1 diabetes.
Identifieur interne : 000819 ( PubMed/Checkpoint ); précédent : 000818; suivant : 000820Telemedical care reduces hypoglycemias and improves glycemic control in children and adolescents with type 1 diabetes.
Auteurs : B. Liesenfeld [Allemagne] ; R. Renner ; M. Neese ; K D HeppSource :
- Diabetes technology & therapeutics [ 1520-9156 ] ; 2000.
Descripteurs français
- Wicri :
- geographic : Allemagne.
English descriptors
- KwdEn :
- Adolescent, Adult, Blood Glucose (analysis), Blood Glucose (metabolism), Blood Glucose Self-Monitoring, Caregivers (education), Child, Child, Preschool, Counseling, Diabetes Mellitus, Type 1 (blood), Diabetes Mellitus, Type 1 (drug therapy), Diabetes Mellitus, Type 1 (rehabilitation), Family Practice, Female, Germany, Humans, Infant, Insulin (administration & dosage), Insulin (therapeutic use), Internal Medicine, Male, Patient Education as Topic (methods), Patient Selection, Rural Population, Self Care, Telemedicine (methods), Telephone, Treatment Outcome.
- MESH :
- chemical , administration & dosage : Insulin.
- chemical , analysis : Blood Glucose.
- chemical , metabolism : Blood Glucose.
- chemical , therapeutic use : Insulin.
- geographic : Germany.
- blood : Diabetes Mellitus, Type 1.
- drug therapy : Diabetes Mellitus, Type 1.
- education : Caregivers.
- methods : Patient Education as Topic, Telemedicine.
- rehabilitation : Diabetes Mellitus, Type 1.
- Adolescent, Adult, Blood Glucose Self-Monitoring, Child, Child, Preschool, Counseling, Family Practice, Female, Humans, Infant, Internal Medicine, Male, Patient Selection, Rural Population, Self Care, Telephone, Treatment Outcome.
Abstract
Education programs for intensive insulin therapy were found to be valuable in improving glycemic control, but, due to low prevalence of type 1 diabetes in children and adolescents, access to those programs varies considerably in rural areas. We report on a telemedical care program that overcomes geographical isolation of patients on intensive insulin therapy. Sixty-one children and adolescents under the age of 26 participated in a telemedical care program. They stored daily information on blood glucose, injected insulin, meals and exercise in a glucosemeter with electronic memory and transferred the data via modem go a remote diabetes center outside of the region. By individual telephone consultations from home, they reviewed the data with a diabetologist at the diabetes center and adjusted their intensive insulin therapy in order to achieve predefined treatment goals. Patients were trained for 19 (6-48) weeks in the program and measured blood glucose 4.9 (1.7-4.9) times daily. Compared to the run-in-period, mean blood glucose had decreased (167 to 158 mg/dL, p < 0.01), standard deviation of blood glucose had decreased (81 to 70 mg/dL, p < 0.001), and frequency of hypoglycemia had decreased (5.2 to 3.3 in 4 weeks, p = 0.01) at the end of the program. The proportion of blood glucose values within the target range (80-180 mg/dL) had increased (47-55%, p < 0.001). HbAlc was reduced by 0.4% (-3.8 to +2.2%, p < 0.05). Telemedical care for intensive insulin therapy is safe, can improve glycemic control, and reduce the number of hypoglycemias in children and adolescents with type 1 diabetes.
DOI: 10.1089/15209150050501970
PubMed: 11469619
Affiliations:
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We report on a telemedical care program that overcomes geographical isolation of patients on intensive insulin therapy. Sixty-one children and adolescents under the age of 26 participated in a telemedical care program. They stored daily information on blood glucose, injected insulin, meals and exercise in a glucosemeter with electronic memory and transferred the data via modem go a remote diabetes center outside of the region. By individual telephone consultations from home, they reviewed the data with a diabetologist at the diabetes center and adjusted their intensive insulin therapy in order to achieve predefined treatment goals. Patients were trained for 19 (6-48) weeks in the program and measured blood glucose 4.9 (1.7-4.9) times daily. Compared to the run-in-period, mean blood glucose had decreased (167 to 158 mg/dL, p < 0.01), standard deviation of blood glucose had decreased (81 to 70 mg/dL, p < 0.001), and frequency of hypoglycemia had decreased (5.2 to 3.3 in 4 weeks, p = 0.01) at the end of the program. The proportion of blood glucose values within the target range (80-180 mg/dL) had increased (47-55%, p < 0.001). HbAlc was reduced by 0.4% (-3.8 to +2.2%, p < 0.05). Telemedical care for intensive insulin therapy is safe, can improve glycemic control, and reduce the number of hypoglycemias in children and adolescents with type 1 diabetes.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">11469619</PMID><DateCreated><Year>2001</Year><Month>07</Month><Day>25</Day></DateCreated><DateCompleted><Year>2001</Year><Month>08</Month><Day>23</Day></DateCompleted><DateRevised><Year>2011</Year><Month>11</Month><Day>17</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">1520-9156</ISSN><JournalIssue CitedMedium="Print"><Volume>2</Volume><Issue>4</Issue><PubDate><Year>2000</Year><Season>Winter</Season></PubDate></JournalIssue><Title>Diabetes technology & therapeutics</Title><ISOAbbreviation>Diabetes Technol. Ther.</ISOAbbreviation></Journal><ArticleTitle>Telemedical care reduces hypoglycemias and improves glycemic control in children and adolescents with type 1 diabetes.</ArticleTitle><Pagination><MedlinePgn>561-7</MedlinePgn></Pagination><Abstract><AbstractText>Education programs for intensive insulin therapy were found to be valuable in improving glycemic control, but, due to low prevalence of type 1 diabetes in children and adolescents, access to those programs varies considerably in rural areas. We report on a telemedical care program that overcomes geographical isolation of patients on intensive insulin therapy. Sixty-one children and adolescents under the age of 26 participated in a telemedical care program. They stored daily information on blood glucose, injected insulin, meals and exercise in a glucosemeter with electronic memory and transferred the data via modem go a remote diabetes center outside of the region. By individual telephone consultations from home, they reviewed the data with a diabetologist at the diabetes center and adjusted their intensive insulin therapy in order to achieve predefined treatment goals. Patients were trained for 19 (6-48) weeks in the program and measured blood glucose 4.9 (1.7-4.9) times daily. Compared to the run-in-period, mean blood glucose had decreased (167 to 158 mg/dL, p < 0.01), standard deviation of blood glucose had decreased (81 to 70 mg/dL, p < 0.001), and frequency of hypoglycemia had decreased (5.2 to 3.3 in 4 weeks, p = 0.01) at the end of the program. The proportion of blood glucose values within the target range (80-180 mg/dL) had increased (47-55%, p < 0.001). HbAlc was reduced by 0.4% (-3.8 to +2.2%, p < 0.05). Telemedical care for intensive insulin therapy is safe, can improve glycemic control, and reduce the number of hypoglycemias in children and adolescents with type 1 diabetes.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Liesenfeld</LastName><ForeName>B</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Diabetes Center, II Department of Medicine, Brüderkrankenhaus, Trier, Germany. b.liesenfeld@gmx.de</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Renner</LastName><ForeName>R</ForeName><Initials>R</Initials></Author><Author ValidYN="Y"><LastName>Neese</LastName><ForeName>M</ForeName><Initials>M</Initials></Author><Author ValidYN="Y"><LastName>Hepp</LastName><ForeName>K D</ForeName><Initials>KD</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016430">Clinical Trial</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Diabetes Technol Ther</MedlineTA><NlmUniqueID>100889084</NlmUniqueID><ISSNLinking>1520-9156</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D001786">Blood Glucose</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D007328">Insulin</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001786" MajorTopicYN="N">Blood Glucose</DescriptorName><QualifierName UI="Q000032" MajorTopicYN="Y">analysis</QualifierName><QualifierName UI="Q000378" MajorTopicYN="N">metabolism</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015190" MajorTopicYN="Y">Blood Glucose Self-Monitoring</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017028" MajorTopicYN="N">Caregivers</DescriptorName><QualifierName UI="Q000193" MajorTopicYN="N">education</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002648" MajorTopicYN="N">Child</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002675" MajorTopicYN="N">Child, Preschool</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003376" MajorTopicYN="N">Counseling</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003922" MajorTopicYN="N">Diabetes Mellitus, Type 1</DescriptorName><QualifierName UI="Q000097" MajorTopicYN="Y">blood</QualifierName><QualifierName UI="Q000188" MajorTopicYN="N">drug therapy</QualifierName><QualifierName UI="Q000534" 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MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010353" MajorTopicYN="N">Patient Education as Topic</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D018579" MajorTopicYN="N">Patient Selection</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012424" MajorTopicYN="N">Rural Population</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012648" MajorTopicYN="N">Self Care</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017216" MajorTopicYN="N">Telemedicine</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D013689" MajorTopicYN="N">Telephone</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2001</Year><Month>7</Month><Day>27</Day><Hour>10</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2001</Year><Month>8</Month><Day>24</Day><Hour>10</Hour><Minute>1</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2001</Year><Month>7</Month><Day>27</Day><Hour>10</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">11469619</ArticleId><ArticleId IdType="doi">10.1089/15209150050501970</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Allemagne</li></country></list><tree><noCountry><name sortKey="Hepp, K D" sort="Hepp, K D" uniqKey="Hepp K" first="K D" last="Hepp">K D Hepp</name><name sortKey="Neese, M" sort="Neese, M" uniqKey="Neese M" first="M" last="Neese">M. Neese</name><name sortKey="Renner, R" sort="Renner, R" uniqKey="Renner R" first="R" last="Renner">R. Renner</name></noCountry><country name="Allemagne"><noRegion><name sortKey="Liesenfeld, B" sort="Liesenfeld, B" uniqKey="Liesenfeld B" first="B" last="Liesenfeld">B. Liesenfeld</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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