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)
Affiliation :
(1) Centre for Diabetes Education and Management, Our Lady of Maryknoll Hospital(2) Department of Medicine & Geriatrics, Our Lady of Maryknoll Hospital
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. A vision statement “We will always be with you along the diabetes journey / 醫護與您,相伴同行 ” was designed for the delineation of a new treatment modality for further promulgation.
Objectives :
To explore 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 5/2024. 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 33 eligible participants were recruited. All of them were monitored by intermittent scanned CGM. Twenty-seven of them were cared by usual practice (Group 1), and the others were monitored by telecare on 5 to 10 days after the application of CGM sensor (Group 2). The mean age of Group 1 and Group 2 were 53.8±13.8 (41% were male) vs 44.5 ±14.7 (50% were male). Their mean duration of being diagnosed diabetes were 20.8±11.3 (Group 1) vs 13.3±7.8 (Group 2). The baseline HbA1c level in Group 2 was higher (Group 1: 8.3±1.7 vs Group 2: 10.3±2.3). 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: 8.3±1.7 vs 7.8±1.4, p=0.007; Group 2: 10.3±2.3 vs 7.7±1.0, p=0.007). Inter-group comparison reflected some compelling effects with significant improvement in TIR (64.6±23.0 vs 65.2±12.6) and hypoglycemia (7.2±9.5 vs 4.8±6.0) were showed in Group 2. The synergistic effects of advance technologies resulted in significant improvements in glycemic control and patient’s safety.