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What is diabetes ? high glucose (sugar) concentration in blood OK , but what else?

Diabeo: a tool forTele-Diabetes, Educating and supporting diabetic patients over distance IGOR TAUVERON CHU Clermont-Ferrand AUVERGNE France . HYPERglycaemia is bad for diabetics. But HYPOglycaemia is not good either.

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What is diabetes ? high glucose (sugar) concentration in blood OK , but what else?

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  1. Diabeo: a tool forTele-Diabetes, Educating and supporting diabetic patients over distanceIGOR TAUVERON CHU Clermont-Ferrand AUVERGNE France

  2. HYPERglycaemia is bad for diabetics But HYPOglycaemia is not good either What is diabetes ?high glucose (sugar) concentration in blood OK , but what else? Call 112 Aim is balance

  3. population 1.3 M area 26 000Km2 hilly région Auvergne Diabetics # 5 % population Diabetologists # 18 qualified diabetologists Perspectives: Reduction in number of GP until 2025 (rural medical deserts) Increasing number of diabetics ( France reached its 2016 target)

  4. For patients with intensified insulin treatment, how can mobile and/or web technology help to decide their proper insulin dose ? For patients with type 2 diabetes, how to improve care when introducing insulin ? For isolated patients (type 1 or 2) or health care professionals, how to improve quality of care ?

  5. The DIABEO System A tool to improve the management and the monitoring of patients with type 1 diabetes Electronic Systems helpingdecisionmaking )))))) Remote access to the electronic diary via internet )))))) Electronic diary Bolus Calculator Insulin dose Adaptation Physician Patient

  6. Primary efficacy outcome: the use of DIABEO improves HbA1c at 6 months p = 0,022 p < 0,002 Δ = - 0.9%

  7. Secondary safety endpoints:better BG control without increased risk of hypoglycemia with DIABEO. All hypoglycemic Events Severe hypoglycemic Events (between M0 and M6, % of patients) G1 G2 G3

  8. No more time spent for physicians; patients in G1 and G2 spent nearly five hours more than patients in G3 attending hospital visits. p0.001 Hours - No difference between the 3 groups for total time spent on follow-up - For participants in G1 & G2, an additional 274 ± 178 minutes were spent by participants in G1 and 288 ± 218 minutes for G2 travelling to and from the hospital, carrying out administrative procedures and waiting time, whileG3 participants did not lose overtime.

  9. For patients with Type 2 Diabetes, How can mobile and/or web technology help ? Hindrance : Older people vs technology ? Mass education ? Cost issue and lack of Health Care Professionnel? The goals : To improve patients skill in diet, physical exercise, BG monitoring and treatment adaptation To propose real time Decision Support

  10. Conclusion :the ideal Mobile and Web Diabetes Management Coaching Tool : DietDiectory Telemonitoring Specialized Nurses Diabetologist Real Time Support Decision Decision Support Software Teleconsultation Or Integrated CGM Either Plug-in Glucometer

  11. Diabetologist Dietician Specialized Nurses Telemonitoring Teleconsultation Decision Support Software Real Time Support Decision Teleassistance Teleexpertise ??? Or Integrated CGM Either Plug-in Glucometer

  12. Acknowledgements Dr Béatrice ROCHE Nurse team Diabétologie Dr Guillaume CHARPENTIER Diabétologie itauveron@chu-clermontferrand.fr

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