Telemonitoring of Type 2 Diabetes Mellitus in Italy

Abstract

Background: Type 2 diabetes mellitus (DM) affects 382 million people worldwide.

Introduction: This study aimed at assessing whether telemonitoring (TM) of DM patients improves health-related quality of life (HRQoL).

Materials and methods: As part of the RENEWING HEALTH project, 299 DM patients with HbA1c >7.0% were enrolled in a randomized controlled trial, with 208 patients in the TM group and 91 patients in the usual-care group. TM electronically transmitted glucose measurements to physicians during a 12-month follow-up. The SF-36v2 questionnaire was used to assess HRQoL.

Results: In a total of 243 patients analyzed, the study did not identify any clinically important improvement in HRQoL, our primary endpoint. There was no statistically significant difference in HbA1c between the two groups; however, outpatient visits and planned hospitalizations were significantly reduced in the TM group (p < 0.0001 and p = 0.02).

Discussion: The results regarding HRQoL might be, at least in part, an artifact stemming from the criteria used to select patients. TM reduced ambulatory visits and planned hospital admissions, an important result that plausibly reflects the fact that clinicians can strictly monitor their patients' health status without face-to-face contacts.

Conclusions: Enhancement of HRQoL should represent the most critical goal of DM healthcare delivery. Effects of TM on HRQoL of diabetic patients should be studied further.

Keywords: blood glucose monitoring; chronic disease management; diabetes mellitus; health technology assessment; telemedicine; telemonitoring.