TELEDIAB: more quality of life with less costs

Project: TELEDIAB is a project to evaluate telecare of type-1-diabetic people regarding technical implementation as well as cost-effectiveness.

Patient with new onset diabetes as well as those, whose glucose metabolism is out of control and can not be restored by the own skills, that have been trained in a structured education. Because in many countries, namely in Germany, an area-wide professional care of patients with intensive insulin therapy and/or insulin pump therapy (CSII) is not the case, telecare of diabetic patients offers several advantages. This is particularly the case if the distance to the next special care unit is substancial and/or the diabetic individual cannot drive such a long distance because of professional or familial reasons.

Evaluation: It could be shown, that de novo adjustment and readjustment of patients with diabetes can be accomplished by repeated transmission of patients diabetes diary data to their diabetes specialist followed by telephone advice as to the dose and the time and frequency of BG-monitoring required. This telephone advice normally takes 15 minutes.on average. Medical quality, taken from HbA1c is equal to the outcome of conventional care (with the same specialist).

Costs: in a cost-scenario, costs were about 600 Euro per patient and year lower in telecare , because travelling costs and associated opportunity costs do not apply.

Summary: Telemedicine for the metabolic readjustment and control of patients with type-1-diabetes that are out of control and do not show the desired HbA1c value is cost-effective. Furthermore, the patients appreciate the technology and the method whereby they send the data to the diabetes specialist and receive advice by phone. We believe telecare in diabetes should be restricted to certain patient groups and evaluated methods. Users can be clinics or specialists in ambulatory care. 

 * Methods for data transmission:

* Special modem (ACCULINK) and data management program Accucheck CAMIT pro ( Roche Diagnostics).

* Data-transfer via an encrypted file (email attachement) to be integrated into the data-management program DIABASS pro (Fa. Mediaspects, Konstanz).

This project was awarded with the Clinic Award 2002 of the Bayerischen Landesbank.

(l.to r..) Michael Doranth, speaker of general management BayernLB, Dr.Eberhard Biermann, Prof. Dr. Eberhard Standl, both. Schwabing City Hospital, Dr. Peter Kahn, deputy CEO,;Dr. Wolfgang Dietrich, Hospital Schwabing, Minister of State Barbara Stamm between other laureates .