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Intensive remote monitoring versus conventional care in type 1 diabetes: A randomized controlled trial

Laura Gandrud1, Aylin Altan2, Paul Buzinec3

  • 1Children's Minnesota, St. Paul, Minnesota.

Pediatric Diabetes
|February 22, 2018
PubMed

Insights

Intensive remote therapy (IRT) improved glycemic control and quality of life in children with type 1 diabetes (T1D). Adolescents showed greater benefits but struggled to maintain them post-intervention.

Area of Science:

  • Pediatric Endocrinology
  • Digital Health Interventions
  • Diabetes Management

Background:

  • Frequent diabetes care provider contact can improve glycemic control in type 1 diabetes (T1D).
  • In-person visits for T1D management are resource-intensive and costly.
  • Novel remote therapy approaches are needed to optimize pediatric T1D care.

Purpose of the Study:

  • To evaluate the impact of an intensive remote therapy (IRT) intervention on pediatric patients with T1D.
  • To assess changes in glycemic control (HbA1c) and diabetes-related quality of life (QoL).
  • To compare IRT with conventional care (CC) in a randomized controlled trial.

Main Methods:

  • Pediatric T1D patients were randomized to IRT or CC for 6 months.
  • Both groups attended quarterly clinic visits and uploaded device data.
  • IRT involved remote data review and patient contact for regimen adjustments.

Main Results:

  • The IRT group showed a trend towards greater HbA1c reduction (-0.34% vs -0.05%, P=.071) overall.
  • Adolescents (13-17 years) in the IRT group experienced a significant HbA1c decrease (-0.50% vs -0.06%, P=.056).
  • Diabetes-related QoL improved more in the IRT group (6.5 vs 1.3 points, P=.062).

Conclusions:

  • Intensive remote therapy (IRT) positively impacted diabetes metrics and QoL in pediatric T1D patients.
  • Adolescents demonstrated a more pronounced treatment effect from IRT.
  • Sustaining glycemic control improvements after IRT cessation was challenging for adolescents.
Abstract

Keywords:
pediatricsrandomized controlled trialremote consultationremote monitoringremote sensing technologytype 1 diabetes

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