In an oral presentation at American Diabetes Association, San Diego, California this year, Dr. Jothydev Kesavadev lectured on ‘A1c, BP and LDL goals: Successful Use of Telemedicine (DTMSTM) in 1000 Compliant T2DM subjects over 6 months'.

The major barriers to reach treatment targets in diabetes are fear of hypoglycemia and non adherence to instructions on drug dosages and life style modifications. Diabetes Tele-Management System (DTMS®) is one approach which combines slow, steady titration of drugs with repeated tele counselling. DTMS® comprises of a multi-disciplinary team of doctors, dieticians, educators, nurses, pharmacists & psychologist, aided with customised electronic medical records. Patients report 4-point SMBG values (fasting and 2hrs after each main meal) and 3am and other special values as and when needed, through phone, email or website, with individualized frequency. team DTMS® follows up after each report/query on modifications of drug dosages, diet, exercise & offers continuing patient education. Dosage titration with DTMS® minimises risk of low sugars and also saves cost and time of frequent physical visits.

This retrospective study of 1000 compliant patients, age 30-75 yrs with no severe co-morbidities, shows DTMS effective, with highly statistically significant reductions of glycemic and cardiovascular risk parameters from baseline to 6 months. Average A1c at baseline was 8.5% (1.4) compared to 6.2% (0.6) at 6 months. The study also analysed fasting blood sugar, serum creatinine, lipid profiles and blood pressure measured at three physical visits. All parameters showed statistically significant changes, of which the changes in LDL, total cholesterol and FBS appear most clinically significant.

The study concludes DTMS®, based on telefollow-up and multidisciplinary care combined with SMBG, to be safe and cost-effective in the intensive treatment of type 2 diabetes patients without serious co-morbidities, while avoiding limitations of traditional health care such as physical visit for each dose, diet, and exercise adjustment.