Effectiveness and Cost-effectiveness of a Telemonitoring Program for Diabetic People at Home

Effectiveness and Cost-effectiveness Analysis of a Telemonitoring Program on Lifestyle for People With Type 2 Diabetes at Home. Study Based on a Health Network in Diabetology.

Severity of diabetes is related to the development of disabling and costly complications (12.9 billion euros in 2007). The French High Health Authority recommends a therapeutic education on lifestyle and dietary rules in first-line treatment of Type 2 Diabetes Mellitus. Despite these recommendations, patients often have difficulties to implement dietary recommendations every day. The objective of EDUC@DOM is to help people with diabetes to improve lifestyle and equilibrium of glycaemia in order to avoid or delay chronic complications of diabetes. Our main goal is to assess effectiveness of our telemonitoring program in type 2 patients' care compared to a usual care of diabetes, on the glycaemia of the patients. It is expected that our program leads to a better monitoring of health status, a greater adherence to medical and non-medical prescriptions, an empowerment of the patient, and as a consequence, a more efficient health care consumption.

Inclusion Criteria:

• Patient with type 2 diabetes
• Older than 18 years
• With an insulin treatment or not
• Having a glycemic impairment characterized by 6.5% <HbA1c ≤10
• Having an active internet connection at home.
• Accepting the terms of training, loan and use of the device
• Benefiting from social protection system
• Having given his/her free and informed consent and signed the consent

Exclusion Criteria:

• Serious illness recently (<3 months) or decompensated may influence glycemic control of the patient permanently according to the judgment of the physician in charge of monitoring
• Retinal state that does not allow optimization in equilibrium of glycaemia
• Known severe renal impairment defined by creatinine clearance <30ml/min
• Known hemoglobinopathy
• Visual or intellectual resulting inability to use the remote monitoring tool according to the judgment of the physician in charge of monitoring
• Inability to understand all or part of the software information according to the judgment of the physician in charge of monitoring
• Subject to disabled
• Person with severe behavioral disorders (anorexia, bulimia, ...) according to the judgment of the physician in charge of monitoring
• Person who had, or in preparation for bariatric surgery (software nutrition education are not suitable for this type of care.)
• Person with a medical device implanted electronic pacemakers and defibrillators with cardiac (possibility of interference with the impedance)
• Another person involved in research including a period of ongoing exclusion to inclusion,
• A person under legal protection
• Subject living in institutions
• Desire for pregnancy, pregnancy or breastfeeding