[Remote glycemic control using devices for wireless data transmission in children with type 1 diabetes mellitus: interim results of clinical approbation].

Abstract

Despite marked improvements in glycemic control in recent years, many patients with type 1 diabetes mellitus (T1DM) do not achieve glycated hemoglobin (HbA1c) targets.Considering the need for regular interaction between a doctor and a patient with T1DM, and taking into account the geographical features of the Russian Federation, the use of telemedicine can help improve the effectiveness of treatment.

Objective:  To evaluate the clinical effectiveness of remote glycemic control using devices for wireless data transmission in children with type 1 diabetes mellitus.

Materials and methods:  Inclusion criteria: Age from 1 to 18 years, diagnosis of T1DM, intensive insulin therapy (through multiple insulin injections or continuous subcutaneous insulin infusion). The duration of the study was 12 months, during which each participant had at least 5 face-to-face consultations and at least 8 remote consultations. Remote monitoring was performed using the OneTouch Reveal (OT Reveal) mobile application.

Results:  A total of 58 patients with T1DM aged 1 to 18 years were included in the study. The HbA1c level during the study period decreased from 7.6% [7.0; 8.7] at baseline to 7.2% [6.5; 8.2] by the end of the study, after 12 months of follow-up (p=0.025). It should be noted that the best glycemic control was observed after 3 months of observation (HbA1c -7.2% [6.5; 8.5], number of children with HbA1c<7.0% - 44% (31-59)). The median % of measurements in the target range from 3.9 to 10.0 mmol/L increased from 51.1% [38.9; 63.6] at baseline to 59.6% [46.9; 69.8] (p=0.03).

Conclusion:  Using a glucose meter in combination with diabetes management software and remote data transfer capabilities is associated with significant improvements in glycemic control in children with T1DM. Further results of clinical testing will allow a more detailed assessment of the effectiveness of this approach, but it can already be said that wider use of these opportunities may improve the availability of medical care and achieve better compensation for many patients with T1DM.