Modem Transmission of Glucose Values Reduces the Costs of and Need for Clinic Visits

Response to Perlemuter and Yomtov

We thank Perlemuter and Yomtov (1) for their comments in this issue of Diabetes Care regarding our article (2). It seems that their previous study (3) and our study show similar results. They did not provide the ages of their participants, but “nine men and one woman” are mentioned, and our suspicion is that these subjects were a bit older than those in our population. It was also not stated if the subjects had type 1 or type 2 diabetes, though the latter seems likely. As our study dealt specifically with people 15–20 years of age with type 1 diabetes, it is likely that the two experiences are complementary. The main difference between our studies is in the response method, e-mail versus telephone. There are advantages to both methods. E-mail saves time when compared with the necessary repeat phone calls when people are not at home. The telephone allows person-to-person contact in which questions and answers can be used to reach a conclusion. It is also not as limited in dealing with the drawback mentioned by Perlemuter and Yomtov, that of dealing with emergencies. Currently, our clinic staff very effectively handles 20–30 calls per day related to ketones (4) or hypoglycemia. Subjects currently using e-mail switch to telephone calls for emergencies. A major goal of our study was to determine if e-mail communication could reduce the need for clinic visits for some subjects, and this was shown to be the case. We certainly agree that the electronic transmission of medical data is feasible and beneficial.