Metabolic control and satisfaction in a diabetes education programme in flash glucose monitoring through telemedicine in type 1 diabetes

Endocrinol Diabetes Nutr (Engl Ed). 2023 Jun-Jul;70(6):408-414. doi: 10.1016/j.endien.2022.01.009. Epub 2022 Nov 28.

Abstract

Objective: To evaluate metabolic control and satisfaction with a telemedicine diabetes education programme for the initiation of flash glucose monitoring (FGM) in type 1 diabetes.

Material and methods: Prospective study in 48 patients (52.1% women, 22.9% on insulin pump) who started FGM. They were analysed at baseline and 3 months after the beginning of the FGM. The results were compared with an on-site learning cohort matched by age, sex and HbA1c.

Results: At the beginning and 3 months after the MFG, HbA1c improvement was observed (7.9±1.4 vs 7.3±1.1%), p<0.01; with a decrease in time below range - TBR - (4.7±4.9 vs 3.5±3.5%), p<0.05 and number of hypoglycaemic events (9.4±8.7 vs 6.9±5.7/15 days), p<0.05, associated with a worsening in time above range - TAR - (33.5±19.9 vs 37.0±20.9%), p<0.05. No significant differences were observed in the TIR 70-180mg/dl (61.7±18.6 vs 59.4±20.0%), glycemic variability or the use of FGM. Patient satisfaction with telemedicine training was 4.8±0.3 out of 5. No significant differences were observed in the follow-up, either in HbA1c or other glucometer parameters between on-site and online training. In a multivariate analysis adopting the HbA1c at follow-up as the dependent variable, only the TIR (β=-0.034; p<0.001) and the initial HbA1c (β=0.303; p<0.001) maintained statistical significance, unrelated to the on-site or online training (β=0.136; p=ns).

Conclusions: A telemedicine programme is an adequate tool for training in FGM, with results similar to on-site training, and it was associated with a high degree of satisfaction.

Keywords: Diabetes tipo 1; Educación diabetológica; Flash glucose monitoring; Monitorización flash de glucosa; Telemedicina; Telemedicine; Therapeutic education; Type 1 diabetes.

MeSH terms

  • Blood Glucose / metabolism
  • Blood Glucose Self-Monitoring / methods
  • Diabetes Mellitus, Type 1* / drug therapy
  • Female
  • Glycated Hemoglobin
  • Humans
  • Male
  • Personal Satisfaction
  • Prospective Studies

Substances

  • Blood Glucose
  • Glycated Hemoglobin