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TELEMEDICINE MAY HELP IMPROVE CARE OF DIABETES

Research from the past few years has hinted at the possibility that the Internet could bring back doctor visits to patient homes through 'virtual' house calls. Now, results of a new study suggest that diabetics can better maintain their health with the help of "e-medicine.''

In a study involving 28 patients with type 2 diabetes, US Army researchers found that home consultations via computer helped the patients keep their blood sugar levels in check--a goal that is key to preventing diabetes complications such as kidney damage, eye disease, and nerve damage.

Patients who received the virtual house calls over a 3-month period saw their blood sugar levels drop an average of 16%, while their weight fell 4% on average. Weight loss and maintaining a normal weight are important in controlling diabetes.
A team led by Col. Alan Mease of the Southeastern Regional Medical Center at Fort Gordon, Georgia, reports the findings in the August issue of Military Medicine.
E-medicine, also known as "telemedicine,'' can include features such as real-time video conferencing between patients and doctors or among doctors. It has, for instance, been used to connect doctors at small community hospitals with specialists at larger centers to help in diagnosing and treating patients.

In the current study, patients in the telemedicine group were given a computer system that included a blood pressure monitor, and that allowed video and audio connections through a telephone line. Each week, the patients had a video conference with a nurse who talked with them about nutrition, exercise, and the importance of sticking with their medication. The nurses used e-mail to keep the patients' doctors up to date. Patients in the 'control' group received traditional care--meaning they were encouraged to regularly visit their doctors and to attend diabetes education courses.

After 3 months, the telemedicine group had achieved greater reductions in blood sugar. And while the average weight fell among members of the telemedicine group, average weight in the control group actually crept up. Diabetics on intensive therapy to keep near-normal blood sugar are believed to live an average of 5 years longer than those with less-controlled sugar levels, the report indicates.

Mease and colleagues conclude that telemedicine is a valuable tool in treating diabetes, and that further developments in technology "can lead to enhanced e-medicine to provide informed collaborative care systems for patients and healthcare providers.''

SOURCE: Military Medicine 2000;165:579-584

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