Latest news with #telemonitoring
Medscape
3 days ago
- Business
- Medscape
Telemonitoring Boosts Glycaemic Control in T2D
Compared with standard-of-care practices according to the European Association for the Study of Diabetes (EASD) and American Diabetes Association (ADA) consensus report, telemonitoring with continuous glucose monitoring (CGM) and connected insulin pens improved glycaemic control in patients with type 2 diabetes (T2D), showing a 13.6% increase in the time in range for CGM. METHODOLOGY: Researchers in Denmark conducted a clinical trial to assess the effectiveness and safety of telemonitoring among patients with T2D treated with insulin. They included 331 patients with a diagnosis of T2D for 12 months or more (mean age, 61.3 years; 61.6% men) and randomly assigned them to the telemonitoring or standard-of-care group over a 3-month period. The telemonitoring group used a continuous glucose monitor, a connected insulin pen, an activity tracker, and related smartphone applications; the clinical staff monitored their data and provided telephonic support at least three times during the trial and were capable to give advice on adjusting insulin doses after consulting a physician. The standard-of-care group received care according to the EASD-ADA consensus report; they used a continuous glucose monitor during the first and last 20 days of the trial and a connected insulin pen, with participants and the clinical staff having no access to data during the trial. The primary outcome measure was a change from baseline in the time in range for CGM (3.9-10.0 mmol/L), and secondary endpoints included changes from baseline in the A1c level, total daily insulin dose, and time both below and above range for CGM at 3 months. TAKEAWAY: Compared with the standard-of-care group, the telemonitoring group demonstrated significantly superior glycaemic control with an estimated treatment difference of 13.6% in the time in range for CGM ( P = .004). = .004). Compared with standard of care, telemonitoring significantly reduced the A1c level by 7.6 mmol/mol ( P = .001). = .001). The time above range for CGM decreased by 13.1% ( P = .004) in the telemonitoring vs standard-of-care groups, whereas no significant differences in the time below range for CGM and total daily insulin dose were found between groups. = .004) in the telemonitoring vs standard-of-care groups, whereas no significant differences in the time below range for CGM and total daily insulin dose were found between groups. Even though no episodes of severe hypoglycaemia were reported in either group, two serious adverse events related to the trial occurred in the telemonitoring group, where participants injected excessive amounts of fast-acting insulin. IN PRACTICE: "Telemonitoring was superior to standard of care in T2D as it effectively and safely improved glycemic control. Future studies should explore the potential of intelligent clinical decision support in telemonitoring of people with T2D to exploit the large amount of data that diabetes technology will generate," the authors wrote. SOURCE: This study was led by Stine Hangaard, Steno Diabetes Center North Denmark, Aalborg University Hospital, Aalborg, Denmark. It was published online on May 24, 2025, in European Journal of Internal Medicine . LIMITATIONS: The telemonitoring group's access to CGM data with the standard-of-care group remaining blinded to them may have underestimated the treatment effect due to immediate behaviour changes. As this was a telemedicine trial, it was not possible to identify specific components of the intervention that contributed to the observed effects. Moreover, the study faced selection bias, as patients who were more comfortable using technology were more likely to participate in the trial. DISCLOSURES: This study received support from the ADAPT-T2D consortium, The Innovation Fund Denmark, and Novo Nordisk A/S. Six authors reported being employees of and having shares in Novo Nordisk A/S. Some others reported receiving consultant fees, unrestricted grants, and travel grants from various pharmaceutical companies.
Medscape
20-05-2025
- Health
- Medscape
Mobile Health Tech May Enhance Heart Failure Care
Compared with usual care, the use of a mobile health technology that integrates telemonitoring and teleintervention during the vulnerable post-discharge period led to a reduction in the risk for new fatal and non-fatal cardiovascular events in patients recently hospitalised for heart failure (HF) decompensation. METHODOLOGY: Researchers conducted a randomised, phase 3, multicentre trial in Spain to assess the efficacy of a non-invasive mobile health service in post-discharge HF care. They included 506 adult patients (mean age, 73 years; 41% women) hospitalised for HF decompensation who were either recently discharged (within the past 30 days) or in the process of discharge planning. After discharge, patients were randomly assigned to receive either mobile health service comprising telemonitoring and preplanned structured healthcare follow-up via videoconference (n = 255) or usual care involving face-to-face visits (n = 251) between May 2018 and April 2022. Usual care followed the HF care framework of each centre and included a nurse-led educational programme on daily monitoring of biomedical data. The mobile health group received care on the basis of their daily biometric data, reported through a smartphone app connected to medical devices. The primary outcome was a composite of cardiovascular death or worsening HF events during the follow-up duration of 6 months. TAKEAWAY: Participants in the mobile health group had a 65% lower risk for the first event of the composite outcome — cardiovascular death or worsening HF events — than those in the usual care group (hazard ratio, 0.35; P < .0001). < .0001). The risk for a first event of worsening HF was 70% lower ( P < .0001) and that of cardiovascular death was 54% lower ( P = .047) in participants allotted to the mobile health group. < .0001) and that of cardiovascular death was 54% lower ( = .047) in participants allotted to the mobile health group. Compared with the usual care group, the mobile health group had a lower risk for non-fatal events and fewer occurrences of all-cause mortality and cardiovascular hospitalisations and showed improvements in self-care and quality of life. No spontaneously reported harms were reported in either of the groups. IN PRACTICE: "Integration of an eHealth [electronic health]-based solution into usual health-care systems and provision of a user-friendly interface for patients to promote adherence and persistence are two key aspects that likely contributed to the efficacy of mHealth [mobile health] in this trial," the authors wrote. SOURCE: This study was led by Sergi Yun, MD, and Josep Comín-Colet, PhD, Bellvitge Biomedical Research Institute, L'Hospitalet de Llobregat, Barcelona, Spain. It was published online on May 14, 2025, in The Lancet Digital Health . LIMITATIONS: Data related to ethnicity of the patients were not recorded. The protocol allowed for local variations in standard care at each centre, which may have contributed to differences in data. DISCLOSURES: This trial received an unrestricted grant from Novartis. The authors declared having no competing interests.
