Martínez-Sarriegui Iñaki, García-Sáez Gema, Rigla Mercedes, Brugués Eulalia, de Leiva Alberto, Gómez Enrique J, Hernando Elena M
Bioengineering and Telemedicine Group, Polytechnic University of Madrid, Madrid, Spain.
J Diabetes Sci Technol. 2011 Jan 1;5(1):5-12. doi: 10.1177/193229681100500102.
The combination of telemedicine systems integrating mobile technologies with the use of continuous glucose monitors improves patients' glycemic control but demands a higher interaction with information technology tools that must be assessed. In this article, we analyze patients' behavior from the use-of-the-system point of view, identifying how continuous monitoring may change the interaction of patients with the mobile telemedicine system.
Patients' behavior were evaluated in a clinical experiment consisting of a 2-month crossover randomized study with 10 type 1 diabetes patients. During the entire experiment, patients used the DIABTel telemedicine system, and during the intervention phase, they wore a continuous glucose monitor. Throughout the experiment, all user actions were automatically registered. This article analyzes the occurrence of events and the behavior patterns in blood glucose (BG) self-monitoring and insulin adjustments. A subjective evaluation was also performed based on the answers of the patients to a questionnaire delivered at the end of the study.
The number of sessions established with the mobile Smart Assistant was considerably higher during the intervention period than in the control period (29.0 versus 18.8, p < .05), and it was also higher than the number of Web sessions (29.0 versus 22.2, p < .01). The number of daily boluses was higher during the intervention period than in the control period (5.27 versus 4.40, p < .01). The number of daily BG measurements was also higher during the intervention period (4.68 versus 4.05, p < .05) and, in percentage, patients increased the BG measurements not associated to meals while decreasing the percentage of preprandial measurements. The subjective evaluation shows that patients would recommend the use of DIABTel in routine care.
The use of a continuous glucose monitor changes the way patients manage their diabetes, as observed in the increased number of daily insulin bolus, the increased number of daily BG measurements, and the differences in the distribution of BG measurements throughout the day. Continuous monitoring also increases the interaction of patients with the information system and modifies their patterns of use. We can conclude that mobile technologies are especially useful in scenarios of tight monitoring in diabetes, and they are well accepted by patients.
将移动技术与连续血糖监测仪相结合的远程医疗系统，可改善患者的血糖控制，但需要与必须评估的信息技术工具进行更多互动。在本文中，我们从系统使用的角度分析患者行为，确定连续监测如何改变患者与移动远程医疗系统的互动。
在一项针对10名1型糖尿病患者的为期2个月的交叉随机研究的临床实验中评估患者行为。在整个实验过程中，患者使用DIABTel远程医疗系统，在干预阶段，他们佩戴连续血糖监测仪。在整个实验过程中，所有用户操作都会自动记录。本文分析血糖（BG）自我监测和胰岛素调整中事件的发生情况和行为模式。还根据患者在研究结束时对问卷的回答进行了主观评估。
干预期间与移动智能助手建立的会话次数明显高于对照期（29.0对18.8，p <.05），也高于网络会话次数（29.0对22.2，p <.01）。干预期间每日推注胰岛素的次数高于对照期（5.27对4.40，p <.01）。干预期间每日BG测量次数也更高（4.68对4.05，p <.05），而且患者增加了与进餐无关的BG测量次数，同时降低了餐前测量的百分比。主观评估表明患者会推荐在常规护理中使用DIABTel。
如每日胰岛素推注次数增加、每日BG测量次数增加以及全天BG测量分布的差异所示，使用连续血糖监测仪改变了患者管理糖尿病的方式。连续监测还增加了患者与信息系统的互动并改变了他们的使用模式。我们可以得出结论，移动技术在糖尿病密切监测的情况下特别有用，并且患者对其接受度很高。
