Optimizing care for people with diabetes mellitus using telemedicine

Diabetes mellitus affects around nine percent of the population in Germany, and forecasts predict that this percentage will increase in the future. Many patients receive intensified insulin therapy, which is time-consuming, organizationally complex and requires intensive doctor-patient contact. This study was initiated on the assumption that consistent monitoring combined with individual medical care supported by telemedicine can significantly contribute to improving or stabilizing the metabolism of people with diabetes mellitus. The telemedical approach was based on consistent glucose measuring, which was transmitted electronically to the physician.

The evaluation was to investigate whether the care of patients with diabetes mellitus and intensified insulin therapy using telemedicine leads to an improvement in the glycemic metabolic status. The primary endpoint was the HbA1c level. The secondary endpoints were the additional costs of the intervention, further indicators of the glycemic metabolic status, the feasibility of the approach in the daily practice and in the daily life of the patients, and the patients’ satisfaction with the therapy. Data collection and project implementation were conducted from 01.10.2018 through 31.07.2019. The target groups of the project were patients with diabetes mellitus type-1 and type-2 as well as the treating physicians.

To provide answers to the research questions, a quasi-experimental study with a pre-post design was conducted. Within the study period of six months, there were two (patients) and three (physicians) survey time points. For the interviews, both self-developed and standardized questionnaires were used. Depending on the research question and endpoint, descriptive and/or inferential statistical analyses were used. Statistical data analysis was performed using SPSS Subscription Version 2019.