A Comparison of Diabetes Education Administered Through Telemedicine Versus in Person
- Roberto E. Izquierdo, MD1,
- Paul E. Knudson, MD1,
- Suzanne Meyer, RN, CDE1,
- Joann Kearns, RD, CDE1,
- Robert Ploutz-Snyder, PHD1 and
- Ruth S. Weinstock, MD, PHD12
- 1SUNY Upstate Medical University, Syracuse, New York
- 2Veterans Administration Medical Center, Syracuse, New York
OBJECTIVE—To determine whether diabetes education can be provided as effectively through telemedicine technology as through in-person encounters with diabetes nurse and nutrition educators.
RESEARCH DESIGN AND METHODS—A total of 56 adults with diabetes were randomized to receive diabetes education in person (control group) or via telemedicine (telemedicine group) and were followed prospectively. The education consisted of three consultative visits with diabetes nurse and nutrition educators. The in-person and telemedicine groups were compared using measures of glycemic control (HbA1c) and questionnaires to assess patient satisfaction and psychosocial functioning as related to diabetes. Outcome measures were obtained at baseline, immediately after the completion of diabetes education, and 3 months after the third educational visit.
RESULTS—Patient satisfaction was high in the telemedicine group. Problem Areas in Diabetes scale scores improved significantly with diabetes education (adjusted P < 0.05, before vs. immediately after education and 3 months after education), and the attainment of behavior-change goals did not differ between groups. With diabetes education, HbA1c improved from 8.6 ± 1.8% at baseline to 7.8 ± 1.5% immediately after education and 7.8 ± 1.8% 3 months after the third educational visit (unadjusted P < 0.001, P = 0.089 adjusted for BMI and age), with similar changes observed in the telemedicine and in-person groups.
CONCLUSIONS—Diabetes education via telemedicine and in person was equally effective in improving glycemic control, and both methods were well accepted by patients. Reduced diabetes-related stress was observed in both groups. These data suggest that telemedicine can be successfully used to provide diabetes education to patients.
- ADS, Appraisal of Diabetes Scale
- DQOL, Diabetes Quality of Life
- DSME, diabetes self-management education
- DTSQ, Diabetes Treatment Satisfaction Questionnaire
- PAID, Problem Areas In Diabetes
Address correspondence and reprint requests to Roberto E. Izquierdo, MD, 90 Presidential Plaza, Syracuse, NY 13202. E-mail:.
Received for publication 26 May 2002 and accepted in revised form 16 December 2002.
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
- DIABETES CARE