Home telemonitoring benefits patients with diabetes

Home telemonitoring plus active medication management by a nurse practitioner resulted in greater reductions in HbA_1c than did a monthly care coordination telephone call in patients with type 2 diabetes in a study reported in the March issue of Diabetes Care.

The study included 150 veterans receiving primary care at the VA Pittsburgh Healthcare System from June 2004 to December 2005. All were taking an oral hypoglycemic agent and/or insulin for a year or more and had HbA_1c levels of at least 7.5 percent at enrollment. They were randomly assigned to undergo home telemonitoring plus active medication management or to receive a monthly care coordination phone call.

All study participants received monthly calls for diabetes education and self-management review purposes. Members of the telemonitoring group also transmitted data related to blood glucose, blood pressure, and weight to a nurse practitioner, who then adjusted their medications for glucose, blood pressure, and lipid control according to American Diabetes Association guidelines.

Although both interventions improved glycemic control in those patients previously without control, those in the telemonitoring group demonstrated significantly greater reductions in HbA_1c by the three-month and six-month points.