The Research Of The Application Of Telemedicine In The Integrated Management Of Type 2 Diabetes

Objective:We established the platform(U-Healthcare) of diabetes remote medical service to explore the mode of the Internet-based integrated management of diabetes,and evaluated its effectiveness and practicality. Methods:220 patients with type 2 diabetes and Hb A1 c ranged from 7% to 10% were recruited from outpatient in our department and randomly assigned into two groups.The experimental group sent data through glucometer which could transmit the data of blood glucose automatically,and got medicine, diet,exercise and other management of U-healthcare system.While the control group received conventional medical treatment without any additional intervention.All patients were regularly followed up by the same medical team every three months. Results:By the 3 month follow up,fasting plasma glucose of the experimental group was lower than the baseline [7.0(5.9,8.0) to 7.9(6.5,9.3)mmol/L,P=0.001],as well as the control group[7.0(5.9,8.0) to 7.4(6.4,8.7)mmol/L,P=0.038] with statistical significance,and triglyceride(TG) of the experimental group was much lower than the baseline[1.7(1.2,2.2) to 2.0(1.5,3.2)mmol/L,P=0.000].After 6 months,two-hour postprandial plasma glucose of the experimental group was improved significantly in comparison with control group [10.2(9.0,12.0)to 10.5(9.0,12.3)mmol/L,P=0.034].The Hb A1 c decreased gradually every three months in the experimental group,and the mean change of Hb A1 c was significantly greater than the control group[(1.27 to 0.68)%,P=0.004].At the end of study,more than 80% of the patients in the experimental group adhered to monitor blood glucose 2~3 days per week,and the compliance degree was 72%. Conclusions:1.Telemanagement played a positive role in glycemic control, lowering Hb A1 c, improving TG of patients with diabetes in a short time.2.Telemedicine of diabetes,which could be complementary with other clinical intervention methods,improved the ability of patients’ self-management, patients’ satisfaction and adherence, having a positive effect on patients’ overall health and quality of life.3.Telemedicine of chronic diseases,such as diabetes,could provide medical services to more people,serve people’s livelihood and the society.