Long-term experiences with a computerized diabetes management and glucose monitoring system in insulin-dependent...

Only a minority of patients use diabetes management systems. In our study, 24 patients were given a memory based blood glucometer (ROMEO, Diva Medical Systems), which additionally allowed the input of insulin doses, food intake and exercise for up to four years. Eight patients returned ROMEO within one month (group I), 8 used the system as long it was available as a loan (group II) and 8 patients bought the system (group III). The patients of group III had a significantly better diabetic control (HbA1 = 7.8% +/- 0.7 (S.D.) vs. 11.7 +/- 3.6 (group I) and 10.7 +/- 2.6 (group II)) and were more reliable in their input of the data. After 3 years, however, only five patients of group III continued to use the system, but as a glucose meter only. One patient used the options of the system. These data show that glycemic control is not a question of the equipment. After a certain period, even the well-motivated patients do not use the system options routinely. Obviously, the advantages of the system are only used by a minority of patients characterized by good metabolic control and good compliance, and even these patients do not persistingly use all the options of the system after a certain period of time.