AUTHOR=Ballesta Sílvia , Chillarón Juan J. , Inglada Yolanda , Climent Elisenda , Llauradó Gemma , Pedro-Botet Juan , Cots Francesc , Camell Helena , Flores Juana A. , Benaiges David 

TITLE=Telehealth model versus in-person standard care for persons with type 1 diabetes treated with multiple daily injections: an open-label randomized controlled trial

JOURNAL=Frontiers in Endocrinology

VOLUME=14

YEAR=2023

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2023.1176765

DOI=10.3389/fendo.2023.1176765

ISSN=1664-2392

ABSTRACT=<sec><title>Objective</title><p>Increasing evidence indicates that the telehealth (TH) model is noninferior to the in-person approach regarding metabolic control in type 1 diabetes (T1D) and offers advantages such as a decrease in travel time and increased accessibility for shorter/frequent visits. The primary aim of this study was to compare the change in glycated hemoglobin (HbA<sub>1c</sub>) at 6 months in T1D care in a rural area between TH and in-person visits.</p></sec><sec><title>Research design and methods</title><p>Randomized controlled, open-label, parallel-arm study among adults with T1D. Participants were submitted to in-person visits at baseline and at months 3 and 6 (conventional group) or teleconsultation in months 1 to 4 plus 2 in-person visits (baseline and 6 months) (TH group). Mixed effects models estimated differences in HbA<sub>1c</sub> changes.</p></sec><sec><title>Results</title><p>Fifty-five participants were included (29 conventional/26 TH). No significant differences in HbA<sub>1c</sub> between groups were found. Significant improvement in <italic>time in range</italic> (5.40, 95% confidence interval (CI): 0.43-10.38; p &lt; 0.05) and in <italic>time above range</italic> (-6.34, 95%  CI: -12.13- -0.55;p &lt; 0.05) in the TH group and an improvement in the Diabetes Quality of Life questionnaire (EsDQoL) score (-7.65, 95% CI: -14.67 - -0.63; p &lt; 0.05) were observed. In TH, the costs for the participants were lower.</p></sec><sec><title>Conclusions</title><p>The TH model is comparable to in-person visits regarding HbA<sub>1c</sub> levels at the 6-month follow-up, with significant improvement in some glucose metrics and health-related quality of life. Further studies are necessary to evaluate a more efficient timing of the TH visits.</p></sec>