Telehealth model versus in-person standard care for persons with type 1 diabetes treated with multiple daily injections : an open-label randomized controlled trial
Ballesta Purroy, Sílvia (Hospital del Mar (Barcelona, Catalunya))
Chillaron, Juan Jose (Hospital del Mar (Barcelona, Catalunya))
Inglada, Yolanda (Hospital del Mar (Barcelona, Catalunya))
Climent, Elisenda (Hospital del Mar (Barcelona, Catalunya))
Llauradó, Gemma (Hospital del Mar (Barcelona, Catalunya))
Pedro-Botet, Juan (Hospital del Mar (Barcelona, Catalunya))
Cots Reguant, Francesc (Hospital del Mar (Barcelona, Catalunya))
Camell, Helena (Hospital Comarcal de l'Alt Penedès (Vilafranca del Penedès, Barcelona))
Flores-Le Roux, Juana Antonia (Hospital del Mar (Barcelona, Catalunya))
Benaiges, David (Hospital del Mar (Barcelona, Catalunya))
Universitat Autònoma de Barcelona

Data:	2023
Resum:	Increasing evidence indicates that the telehealth (TH) model is noninferior to the in-person approach regarding metabolic control in type 1 diabetes (T1D) and offers advantages such as a decrease in travel time and increased accessibility for shorter/frequent visits. The primary aim of this study was to compare the change in glycated hemoglobin (HbA) at 6 months in T1D care in a rural area between TH and in-person visits. Randomized controlled, open-label, parallel-arm study among adults with T1D. Participants were submitted to in-person visits at baseline and at months 3 and 6 (conventional group) or teleconsultation in months 1 to 4 plus 2 in-person visits (baseline and 6 months) (TH group). Mixed effects models estimated differences in HbA changes. Fifty-five participants were included (29 conventional/26 TH). No significant differences in HbA between groups were found. Significant improvement in time in range (5. 40, 95% confidence interval (CI): 0. 43-10. 38; p < 0. 05) and in time above range (-6. 34, 95% CI: -12. 13- -0. 55;p < 0. 05) in the TH group and an improvement in the Diabetes Quality of Life questionnaire (EsDQoL) score (-7. 65, 95% CI: -14. 67 - -0. 63; p < 0. 05) were observed. In TH, the costs for the participants were lower. The TH model is comparable to in-person visits regarding HbA levels at the 6-month follow-up, with significant improvement in some glucose metrics and health-related quality of life. Further studies are necessary to evaluate a more efficient timing of the TH visits.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Type 1 diabetes ; Metabolic control ; Telehealth ; Emerging technologies ; Chronic complications
Publicat a:	Frontiers in endocrinology, Vol. 14 (june 2023) , ISSN 1664-2392

DOI: 10.3389/fendo.2023.1176765
PMID: 37441496

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