Summary of the good practice:
The practice aims to validate the clinical efficacy of a telemedicine- and web-based system platform for self- monitoring of blood glucose (SMBG) data transmission and analysis of metabolic control, assessed by measuring changes inHbA1c, in insulin-treated diabetic patients. The system platform involves (i.) systematic (real-time and anywhere) transmission of SMBG data to a decision supported software (DSS)-assisted server, (ii.) web-based analysis of data, and (iii.) feedback on patients and medical staff to implement metabolic control. Additional aims include assessments of patients’ adherence to perform SMBG, analysis of the specific and overall quality of glucose control, identification of situations predictive of hypoglycaemic and/or hyperglycaemic episodes, and detection of episodes of hypoglycaemia and sustained hyperglycaemia.
It is to be expected that use of the telemedicine- and web-bases system platform will result in improved metabolic control as compared with standard of care, as shown by a greater decrease in HbA1c from baseline. In addition, it will potentially result in better quality of glucose monitoring and control (e.g., appropriateness of SMBG testing, glucose excursions, indexes of glucose variability) and frequency and severity of hypoglycaemic episodes. Also, quality of life should be improved in the telemedicine group. Thus, patients and physicians will be provided with a tool that allows to verifying the appropriateness of SMBG in relation to the diabetes status, and this will be also relevant to “payers” (false glucose reporting and data collection will be avoided, patient/physician interaction will be optimized while limiting the number of medical visits).
Challenge addressed by the good practice
- Provide patients and physicians with a tool that allows to verify the appropriateness of SMBG in relation to the diabetes status.
- Analyze the quality of glucose control with new parameters (extent of hyper/hypoglycaemia episodes, risk of hyper/hypoglycaemia, glucose levels related to meals, hyper/hypoglycaemia episodes and emergencies).
- Provide immediate feed-back to the patient to manage severe hypoglycaemia/ hyperglycaemia.
- Provide patient with detailed information on glucose data which may strengthen perception of diabetes control.
- Avoid false glucose reporting and data collection.
Key innovative elements of the good practice
- Allowed to verify the appropriateness of SMBG in relation to the diabetes status and to identify a significant proportion of patients not performing SMBG according to current guidelines.
- Enabled timely (real-time) identification of patients with uncontrolled diabetes before the scheduled visit, as well as patients at risk of hyper/hypoglycaemia and specific hypoglycaemia emergencies.
- Provided immediate feedback to the patient to manage severe hypoglycaemia/hyperglycaemia.
- Provided patients with detailed information on glucose data which may strengthen perception of diabetes control.
- Avoided false glucose reporting and generated data collection suitable for scientific analyses.
Full Scirocco information on the good practice
Publications and reports on the good practice
Contact point: Francesco Giorgino, MD, PhD; firstname.lastname@example.org