1 Department of Internal Medicine, Kyungpook National University School of Medicine , Daegu, Republic of Korea.
2 Department of Internal Medicine, Yeungnam University College of Medicine , Daegu, Republic of Korea.
Telemed J E Health. 2018 Aug;24(8):604-613. doi: 10.1089/tmj.2017.0203. Epub 2018 Jan 17.
This study was performed to determine the effectiveness of the Smart Care service on glucose control based on telemedicine and telemonitoring compared with conventional treatment in patients with type 2 diabetes.
This 24-week prospective multi-center randomized controlled trial involved 338 adult patients with type 2 diabetes at four university hospitals in South Korea. The patients were randomly assigned to a control group (group A, n = 113), a telemonitoring group (group B, n = 113), or a telemedicine group (group C, n = 112). Patients in the telemonitoring group visited the outpatient clinic regularly, accompanied by an additional telemonitoring service that included remote glucose monitoring with automated patient decision support by text. Remote glucose monitoring was identical in the telemedicine group, but assessment by outpatient visits was replaced by video conferencing with an endocrinologist.
The adjusted net reductions in HbA1c concentration after 24 weeks were similar in the conventional, telemonitoring, and telemedicine groups (-0.66% ± 1.03% vs. -0.66% ± 1.09% vs. -0.81% ± 1.05%; p > 0.05 for each pairwise comparison). Fasting glucose concentrations were lower in the telemonitoring and telemedicine groups than in the conventional group. Rates of hypoglycemia were lower in the telemedicine group than in the other two groups, and compliance with medication was better in the telemonitoring and telemedicine than in the conventional group. No serious adverse events were associated with telemedicine.
Telehealthcare was as effective as conventional care at improving glycemia in patients with type 2 diabetes without serious adverse effects.
本研究旨在比较基于远程医疗和远程监测的智能护理服务与常规治疗对 2 型糖尿病患者血糖控制的效果。
这是一项为期 24 周的前瞻性多中心随机对照试验，涉及韩国四家大学医院的 338 名成年 2 型糖尿病患者。患者被随机分为对照组（A 组，n=113）、远程监测组（B 组，n=113）或远程医疗组（C 组，n=112）。远程监测组定期到门诊就诊，并提供远程血糖监测服务，同时通过短信提供自动患者决策支持。远程医疗组的远程血糖监测与远程监测组相同，但通过视频会议由内分泌专家进行门诊评估来替代门诊就诊。
经过 24 周的调整后，常规、远程监测和远程医疗组的 HbA1c 浓度净降低幅度相似（-0.66%±1.03%比-0.66%±1.09%比-0.81%±1.05%；两两比较均 p>0.05）。远程监测和远程医疗组的空腹血糖浓度低于常规组。远程医疗组的低血糖发生率低于其他两组，远程监测和远程医疗组的药物依从性好于常规组。远程医疗未发生严重不良事件。
远程医疗在改善 2 型糖尿病患者的血糖方面与常规治疗一样有效，且无严重不良事件。
