Objective:
A close diabetes team-patient relationship is required for establishing satisfactory metabolic control. The purpose of this study was to investigate the effect of a telehealth system on diabetes control.
Methods:
The study was carried out between June 2015 and January 2016 at the Gazi University Faculty of Medicine, Pediatric Endocrinology Department. The telehealth system was developed by the diabetes team. The demographic characteristics, frequency of use and hemoglobin A1c (HbA1c) changes of type 1 diabetic (T1DM) patients using this communication network were analysed.
Results:
Eighty two patients [43 (52.4%) females, mean (±standard deviation) age 10.89±4 years] used the telehealth system. Fourteen (17.1%) of the cases were on pump therapy and 59 (72.0%) were counting carbohydrates. The individuals with diabetes or their families preferred WhatsApp communication. Whatsapp provided a means for instant messaging in most instances (57.3%), contact with diabetes education nurse (32.9%) and consultation with the diabetes team about insulin doses and blood glucose regulation (42.7%). HbA1c values after six months were significantly lower in patients/parents calling frequently (p<0.001) compared with HbA1c values recorded at the beginning of the study.
Conclusion:
Increase in frequency of counselling by the diabetes team led to improved blood glucose control in T1DM patients. A telehealth system is useful for early detection of the need for changes in treatment and for intervention. It also promoted better self care.
Increase in frequency of counselling to the diabetes team caused the blood glucose control of individuals with diabetes. Telehealth system is a useful system in early detection of the changes and intervention in the status of individual with diabetes, enhancing the patient's self care. Key words: Type 1 diabetes, telehealth, diabetes team, HbA1c.
Background. The life-long course, long-term complications, necessity for regular treatment, and potential side effects of the medications must be well understood by parents of pediatric familial Mediterranean fever (FMF) patients. The aim of this study was to assess parental knowledge and to investigate how parents obtained scientific information about FMF.Methods. One hundred and seventy-one pediatric FMF patients and their parents were enrolled in this crosssectional study. Three-part questionnaires, including forms on socio-demographics, knowledge and perceptions of FMF, and how to get information about FMF, were administered to parents.
Results.In the analysis of the knowledge questions, 90.1% of parents were aware of colchicine as an effective drug for FMF, but only 39.2% of them were aware that there is no vital risk during FMF attacks. Caregivers preferred to obtain information from physicians (98.8%), websites (47.9%), seminars (3.5%), and books (1.7%). The knowledge scores of parents were significantly higher among those whose children were using antiinterleukin-1 therapy in addition to colchicine relative to those on colchicine alone (p = 0.04). There was a positive correlation between knowledge level and parental educational status (p = 0.0001).Conclusions. Knowledge scores among parents of pediatric FMF patients are unsatisfactory. The parents whose children have a severe disease course and a need for anti-interleukin-1 therapy are more knowledgeable. For parents, continuing education programs including books, seminars and web-sites giving information about the course, prognosis, complications and treatments of FMF should be employed immediately after the diagnosis and thereafter.
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