Friday, May 22, 2009

Telemedicine trial cuts diabetes emergencies

A telemedicine experiment in New York has found the technology helps children with Type 1 diabetes manage their condition and led to fewer having to be admitted to hospital.

Type 1 diabetes is the most common chronic childhood disease and needs to be managed using regular glucose measurements with multiple daily injections of insulin, with frequent insulin dose adjustments.

Roberto Izquierdo and colleagues from SUNY Upstate Medical University in Syracuse, New York, studied 41 children between the ages of 5 and 14 years with type 1 diabetes. All of the children received routine care, and 23 of the 41 children were also enrolled in a telemedicine intervention program.

During the initial six month period of use, the telemedicine group experienced improved blood sugar control and led to fewer visits to the emergency department and hospitalisations due to their diabetes. More than 90 per cent of the participants said they would use the programme again.

Izquierdo said: “Children in the telemedicine treatment group were more apt to feel better about their diabetes.”

He claimed the children who used the telemedicine program were more likely to complete the prescribed diabetes care related tasks, which can lead to improved management of the disease.

As a part of routine care, letters containing instructions for each child’s diabetes care were sent to school nurses, who also attended an annual diabetes education program. Additionally, all children visited the diabetes centre at SUNY Medical University every three months, and parents, children, and school nurses communicated with the centre via phone as needed. In addition to receiving regular care, the 23 children enrolled in the telemedicine intervention program attended video conferences with the school nurse and the diabetes centre monthly to discuss treatment orders. Their glucose readings were sent to the centre via the telemedicine unit, and the diabetes nurse practitioners at the centre made adjustments to insulin treatments as needed.

The research was published in the Journal of Pediatrics.

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