[The impact of remote monitoring of glycemia self-control on carbohydrate metabolism and quality of life in patients with type 1 diabetes mellitus].

Abstract

Background: Self-monitoring of blood glucose (SMBG) is the main tool to achieve carbohydrate metabolism targets in patients with type 1 diabetes mellitus (DM). Remote monitoring of SMBG in Russia appeared relatively recently and needs to be evaluated for effectiveness.

Aim: To evaluate the effect of remote monitoring of SMBG on carbohydrate metabolism and quality of life in patients with type 1 DM in order to form new therapeutic approaches.

Materials and methods: Patients with type 1 DM with glycated hemoglobin (HbA1c) from 8.0 to 12.0% were divided into the main (n=107) and control group (n=20). Patients from the main group performed SMBG using glucometers with the possibility of remote data transmission, patients from the control group continued the traditional SMBG. The dynamics of HbA1c, derived time spent in the target ranges, recognition of hypoglycemia (GOLD scale, Clarke questionnaire), quality of life according to the SF-36 questionnaire were evaluated. The statistical analysis was carried out in the SPSS Version 26.0 program (IBM, USA).

Results: In the main group (n=88) the HbA1c was statistically significant decreased after 6 months from 9.0% [8.4; 9.9] to 8.1% [7.4; 9.2] (p<0.001), with SMBG more than 4 times a day - up to 7.3% [7.0; 7.8] (p=0.001). In the control group (n=20), by the 6th month, HbA1c increased to 10.1% [8,9; 11,2] (p=0,010). Derived Time In Range in the main group increased to 69.9±13.0 (95% CI 65.73-74.03; p<0.001); derived Time Above Range significantly decreased to 9.5% [6.4; 15.0] (p<0.001), derived Time Below Range - to 6.7% [2.8; 12.2] (p=0.044); Coefficient of Variation reached 36.3±7.9 (95% CI 33.7-38.8; p<0.001). According to the results of SF-36, the physical and psychological components of the quality of life in the main group significantly improved (p<0.001). Recognition of hypoglycemia improved in the intervention group (-4.5% of patients (p=0.046) according to the Clarke questionnaire; -8% (p=0.008) on the GOLD scale).

Conclusion: Remote monitoring of SMBG is a prospective therapeutic approach due to its positive effect on carbohydrate metabolism and quality of life in patients with type 1 DM.