Authors: (including presenting author): :
LEUNG SM (1), LEUNG HSS (2), MAK KP (2), WONG KK (2), CHAN SKE (1), YUEN YL (1), POON MY (1), YUEN CM (1), CHAK YL (1), CHUN KY (1)
Affiliation: :
(1) Centre for Diabetes Education and Management, Our Lady of Maryknoll Hospital
(2) Department of Medicine & Geriatrics, Our Lady of Maryknoll Hospital
Keyword 3: :
Diabetes Inertia
Keyword 4: :
Continuous Glucose Monitoring
Keyword 5: :
Patient Empowerment
Keyword 6: :
Self-Monitoring
Introduction: :
Tele-diabetes Nurse Clinic (TDNC) was newly established from 1/9/2023, and it facilitated diabetes nurses to timely discuss the Continuous Glucose Monitoring (CGM) findings with patients.
Objectives: :
This study explored the effects of Telecare on physiologic and behavioral problems causing irregular glucose variability.
Methodology: :
Participants with no treatment modification at 3-month prior the CGM were recruited from 6/2023 to 5/2025. Those participants cared by usual practice were categorized into Group 1, whereas the others were monitored by telecare on 5 to 10 days after CGM application in Group 2. Outcome evaluation included Time-in-Range (TIR), number of hypoglycemic attacks detected (%) and the change of HbA1c at baseline (T0) and 2-3 months thereafter (T1). TIR has an accurate predictive value for glycaemia, and the target is > 70%. Paired Sample t Test was used to compare their mean differences.
Result & Outcome: :
Total 66 eligible participants were recruited. All of them were monitored by CGM. Forty-eight (73%) of them were cared by usual practice (Group 1), and the others (27%) were monitored by telecare on 5 to 10 days after CGM application (Group 2). The mean age of Group 1 and Group 2 were 58.8±11.8 (46% were male) vs 43.3 ±14.1 (44% were male). Their mean duration of being diagnosed diabetes were 21.2±11.3 (Group 1) vs 14.1±7.7 (Group 2). There was no significant difference in all the baseline outcome variables between two groups. Both Groups had showed statistically significant improvement in HbA1c level (Group 1: 8.7±1.7 vs 7.8±1.4, p=0.007; Group 2: 10.6±2.2 vs 7.7±1.0, p=0.005), and higher extent of glycemic improvement was shown in Group 2. Inter-group comparison reflected some compelling effects with significant increase in TIR (63.3±13.1 vs 67.8±10.6) and less hypoglycemic attack (7.3±7.5 vs 4.6±6.0) were showed in Group 2. The synergistic effects of advance technologies and diabetes self-efficacy contributed to optimize glycemic control and patient’s safety. The seamless telecare coincided with the vision of the study site “We will always be with you along the diabetes journey”, and the delineation of this new treatment modality should be further promulgation. Reference: Natali Robson & Hassan Hosseinzadeh. (2021). Impact of Telehealth Care among Adults Living with Type 2 Diabetes in Primary Care: A Systematic Review and Meta-analysis of Randomised Controlled Trials. Int. J. Environ Res. Public Health, 18, 1217.
