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使用连续血糖监测系统的 1 型糖尿病儿童的每月视频会诊:ViDiKi 的设计,一项评估远程医疗效益的多方法干预研究

Monthly Video-Consultation for Children With Type 1 Diabetes Using a Continuous Glucose Monitoring System: Design of ViDiKi, a Multimethod Intervention Study to Evaluate the Benefit of Telemedicine.

机构信息

Institute of Social Medicine and Epidemiology, University of Luebeck, Germany.

Department of Pediatric Endocrinology and Diabetology, University Medical Center, Campus Luebeck, Germany.

出版信息

J Diabetes Sci Technol. 2020 Jan;14(1):105-111. doi: 10.1177/1932296819861991. Epub 2019 Jul 17.

Abstract

BACKGROUND

The introduction of continuous glucose monitoring (CGM) implies new challenges for diabetes care. As CGM systems are often directly linked to a web-based software solution, structured telemedicine care using a video-consultation may be a new option for families who care for children with type 1 diabetes mellitus (T1DM).

METHODS

"ViDiKi" (Virtual Diabetes Outpatient Clinic for Children and Youth) is a multicenter controlled trial carried out in Northern Germany. ViDiKi will examine if monthly telemedical consultations, in addition to regular care, will improve glycemic control and psychosocial outcomes. The primary outcome is glycemic control as measured by a change in glycated hemoglobin (HbA1c). A total of 240 participants aged between one year and 16 years using a CGM with multiple daily injections (MDI) or insulin pump therapy were recruited and assigned to a starter group or a six-month waiting control group. The sample size is designed to detect a between-group difference of 0.5% in HbA1c change at six months. Secondary outcomes are variability of blood glucose, health-related quality of life, self-efficacy, and satisfaction with telemedicine. To gain deeper insight into the experience of using telemedicine, qualitative interviews will be conducted. In a health-economic analysis, the costs of telemedicine and a cost-of-care analysis will be calculated.

CONCLUSIONS

The results from the ViDiKi study shall give important information on the feasibility and putative benefits of telemedicine in children with T1DM and their caregivers.

GERMAN CLINICAL TRAILS REGISTER (DRKS): DRKS00012645.

摘要

背景

连续血糖监测(CGM)的引入给糖尿病护理带来了新的挑战。由于 CGM 系统通常直接与基于网络的软件解决方案相关联,因此使用视频咨询进行结构化的远程医疗护理可能是 1 型糖尿病(T1DM)患儿家庭的新选择。

方法

“ViDiKi”(儿童和青少年虚拟糖尿病门诊)是在德国北部进行的一项多中心对照试验。ViDiKi 将研究每月进行远程医疗咨询,除了常规护理外,是否会改善血糖控制和心理社会结局。主要结局是通过糖化血红蛋白(HbA1c)的变化来衡量血糖控制情况。共有 240 名年龄在 1 岁至 16 岁之间的参与者使用 CGM 接受多次每日注射(MDI)或胰岛素泵治疗,他们被招募并分配到起始组或六个月的等待对照组。样本量设计旨在检测六个月时 HbA1c 变化的组间差异为 0.5%。次要结局是血糖变异性、健康相关生活质量、自我效能和对远程医疗的满意度。为了更深入地了解使用远程医疗的体验,将进行定性访谈。在健康经济学分析中,将计算远程医疗的成本和成本效益分析。

结论

ViDiKi 研究的结果将提供有关远程医疗在 T1DM 儿童及其照顾者中的可行性和潜在益处的重要信息。

德国临床试验注册(DRKS):DRKS00012645。

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