One-Year Efficacy and Safety of the Telehealth System in Poorly Controlled Type 2 Diabetic Patients Receiving Insulin Therapy

Objective: To evaluate the functionality of the telehealth system in poorly controlled type 2 diabetic (T2D) patients receiving insulin injections. Materials and Methods: Sixty-four patients with glycosylated hemoglobin (HbA(1c)) values >7% for more than 1 year were included. All patients underwent an intensive diabetes management program, including titration of insulin, blood glucose-self monitoring, and nutritional review, and 32 participated in the telehealth system. The major outcome was to evaluate the change of the HbA(1c) and body weight, the incidence of hospitalization, and hypoglycemic events. Results: After 1-year management, patients receiving telehealth care had significantly improved HbA(1c) levels (9.5%+/-1.8% to 8.1%+/-1.2%; p < 0.01) without significant body weight gain. In contrast, the control group patients had no significant improvement in HbA(1c) levels but showed significant increase in body weight (66.8+/-9.8 to 67.3+/-10.0 kg; p < 0.01). No patient in the telehealth group was hospitalized during the follow-up period, but six patients in the control group were. Intergroup differences in hypoglycemic events were absent. Conclusion: The intensive diabetes management program with the telehealth system is a useful education method to improve blood sugar control and prevent hospitalization in poorly controlled T2D patients receiving insulin injections.