ESPE Abstracts

Background: Telehealth programmes can provide purposeful and relevant solutions to facilitate management and interactions between patients with diabetes and healthcare professionals.

Patients & Methods: A case control study was conducted from June 2021 till August 2022 on 140 children and adolescents with Type 1 diabetes following at outpatient clinic of DEMPU (Diabetes Endocrine and Metabolism Pediatric Unit) at Cairo University children’s hospital. The patients were divided randomly into two groups. Intervention (A) and control (B) groups. Each group contains 70 patients. But 21 patients did not complete the study, lost to follow up. The intervention group will be telemonitored (by mobile phones) with assistance of diabetes educators who were well trained to deal with pediatric diabetes, provide decisions for adjusting fluctuations in blood glucose level and planning their diet. Beside telemonitoring, patients attend their regular visits at outpatient clinic for follow up of HbA1c at the beginning of the study, at 3 and 6 months. In addition to their regular assessment, the numbers of hypoglycemic, severe hyperglycemic or diabetic ketoacidosis (DKA) attacks were recorded. The control group will not undergo telemonitoring, just attending their regular visits at the hospital outpatient clinic. In addition to thorough physical examination, socioeconomic status was assessed in both groups.

Results: Mean age of the study group was 8.68 ± 3.87 years. Incidence of complications (lipodystrophy, proteinuria, dyslipidemia) was statistically significantly higher among group B (37.7%) compared to group A (15.5%) with p-value 0.01. Number of attacks of DKA was statistically significantly higher among group B (18%) compared to (1.7%) in group A with p-value 0.001. There was statistically significant difference between the 2 groups regarding glycemic control. Mean value of HbA1c at the end of the study was (8.21±1.82 SDS) in group A compared to (9.25±2.22 SDS) in group B. There was statistically significant decrease in number of attacks of DKA after the study (34.4%) compared to that before the study (82.7%) in group A with p-value 0.002. There was statistically significant difference in socioeconomic status among the study group with (13.8% & 65.5%) being of very low and low socioeconomic status in group A compared to (14.8% & 39.3%) in group B with p-value 0.01.

Conclusion: The telemedicine approach resulted in substantial improvements in HbA1c in patients with T1DM compared to usual care, as well as reductions in diabetes related complications.