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Telemedicine may improve diabetes care in rural areas
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PHILADELPHIA — Telemedicine has the potential to bring diabetes care to patients in rural areas who would otherwise have little access, a speaker said here.
“The concept of telemedicine is not new; it has been used since the early 19th century where electrocardiograms were transferred by cardiologists through the telephone lines. However, this emergent technology might be of use in endocrinology because of the increased prevalence in endocrine disorders, especially diabetes, in underserved populations. There’s a 17% increased prevalence in diabetes in rural areas as compared to urban areas,” Rabia Rehman, MD, fellow of endocrinology at the University of Tennessee, Health Science Center, Memphis, said at a press conference.
Communication between patient and clinician take place via video conference, Rehman said, allowing patients and physicians to speak one-on-one.
“There’s a nurse present at the remote or distant site where the patient is. She can not only take vital signs, but she can also help the physician with some basic physical exam maneuvers like checking for swelling in the legs or doing a thyroid exam. The physician can also get electronic data from the primary care physicians through fax and give the recommendations back to the primary care physician.”
Rehman and colleagues followed 66 patients aged 58.3 years (73% women) from five rural areas of Tennessee, for 2.5 years. Of the 66 patients, 35 had type 2 diabetes; 27, hypertension; 30, dyslipidemia; 20, thyroid disease; and 8, osteoporosis or hypercalcemia.
Results demonstrated significant improvement in 17 of 20 patients with diabetes on whom data were available (85%), and HbA1c decreased from 9.1% to 7.5% (P≤.002) after approximately 6 months. Additionally, patients with thyroid disease and dyslipidemia appeared to benefit from the intervention.
“It may be a little costly to set up the equipment upfront; however, in the long run, this will be cost-effective, not only for the patients, but also for overall health care. A prospective study to validate the findings of this pilot project may be worthwhile,” Rehman concluded.
For more information:
- Rehman R. Abstract #253. Presented at: the American Association of Clinical Endocrinologists 21st Annual Scientific and Clinical Congress Meeting; May 23-27, 2012; Philadelphia.
Disclosure: Dr. Rehman reports no relevant financial disclosures.
Perspective
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James Thrasher, MD, FACE
I think telemedicine is going to become very interesting. It allows me to see a patient [remotely] if I happen to be in a satellite office. If we have someone come in that I need to communicate with, I can actually see them. I can visually look at anything; if they have a wound, they’re having problems with diabetes, an insulin pump, or on a site; I can actually see it and communicate back with them.
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