Telemedicine in paediatric patients with poorly controlled type 1 diabetes.

We conducted a retrospective study of a telemedicine clinic for paediatric patients with poorly controlled type 1 diabetes. Thirty-one patients (mean age 12 years) were enrolled into the clinic. After an initial visit, a group messaging system was provided to allow communication with the diabetic team which consisted of a diabetic provider, diabetic educator, insulin pump trainer and dietician. Patients and parents were encouraged to make all contacts by electronic means. For urgent matters, direct paging access was provided to the diabetic team. Adjustments in insulin dosing were accomplished via automated web-based communication or email between patient and provider. Compared to baseline, the HbA1c levels were significantly lower at 3 months (9.1% vs. 11.1%, P < 0.05) and 6.5 months (9.5% vs. 11.1%, P < 0.05). There were no significant differences in HbA1c levels for different age categories, insulin delivery methods or number of telemedicine encounters. The study showed that while telemedicine was effective in lowering HbA1c levels, it did not achieve optimum control.