Type 1 Diabetes Mellitus
Conditions
Keywords
Type 1 Diabetes, Telemedicine, Children
Brief summary
The purpose of the study is to look at the effect of replacing the physician only visit by a transmission of information on the participant's current diabetes management and blood glucose monitoring results followed by a phone contact by the diabetes nurse educator. The study will also measure the effect on diabetes control (HbA1c), satisfaction with care, resource utilisation, and costs to the health care system and to the participant. We hypothesize that replacement of the physician-only visit by a virtual visit will not result in worsening of the medical outcomes and that it will result in a reduction in medical resources utilization and costs for families while increasing the satisfaction with care.
Detailed description
Improved metabolic control reduces both the onset and progression of diabetes-related complications in adults and adolescents with type 1 diabetes. Frequency of contact with the medical care team has been associated with better control. Both the American Diabetes Association and Canadian Diabetes Association recommend regular quarterly visits. However, the increase in case loads and the limited manpower available forces us to look at alternative models of care. A model of care in which medical visits alternate between a face to face multidisciplinary visits and a virtual visit done via fax or e-mail communication and a phone call may be advantageous to both the patient and the medical care team. For the patient and his family, this model would decrease time away from school and work, travel inconveniences and costs. For the medical care team it may decrease time per patient and therefore increase the number of patients served with the same resources.
Interventions
OTHERVirtual visit
Participants will alternate between a multidisciplinary visit (MD, RN and RD) and a phone contact with the diabetes nurse educator (the phone contact will replace the physician-only visit). Prior to the phone contact, transmission of information from the participant will be sent through either fax or a web browser.
Sponsors
Canadian Diabetes Association
University of Calgary
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
1 Years to 17 Years
Healthy volunteers
No
Inclusion criteria
* Children: 17 years of age or less * Diagnosis of Type 1 Diabetes for at least 12 months * Currently being followed at the Alberta Children's Hospital Diabetes Clinic.
Exclusion criteria
* Compromised metabolic control (HbA1c \> 10%) * Uncontrolled hypo or hyperthyroidism * Uncontrolled celiac disease * Language or psychosocial barrier preventing the family from completing the study * Diabetes duration of less than 1 year * Participation in other clinical trials with specified clinic visits.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Medical outcomes: HbA1c, rates of severe hypoglycemia, rates of DKA | 1 year |
Secondary
| Measure | Time frame |
|---|---|
| Resource utilization: physicians, nurses, and dietitians, emergency room visits | 1 year |
| Family satisfaction with diabetes care | 1 year |
| Associated costs to the family (time away from school and work, travel, etc) | 1 year |
Countries
Canada
Outcome results
None listed