The Effectiveness of Homecare Telemonitoring in Blood Sugar Control in Patients with Uncontrolled Type 2 Diabetes Mellitus: A Non-randomized Historical Controlled Trial
Article Sidebar
Main Article Content
Abstract
ABSTRACT
Background: Uncontrolled type 2 diabetes mellitus (T2DM) remains a major public health problem. The homecare telemonitoring system is a community-based approach integrating local participation, in which village health volunteers perform fingerstick blood glucose monitoring for patients and send the results via the LINE application for real-time evaluation and feedback by a multidisciplinary team. This study aimed to evaluate the effectiveness of homecare telemonitoring by comparing the mean HbA1c level at 12 weeks with standard outpatient (OPD) care.
Design: Non-randomized historical controlled trial
Methods: This study was conducted among patients with uncontrolled T2DM at Phichit Hospital and Primary Care Units in Mueang Phichit District. The intervention group included 67 patients receiving homecare telemonitoring between January and June 2025, while the control group comprised 132 patients receiving OPD-based care with data retrospectively collected in 2023. Data were analyzed using multivariable Gaussian regression, adjusting for age, sex, body mass index, duration of diabetes, comorbidities, medication regimen, and baseline blood glucose levels.
Results: At 12 weeks, the homecare telemonitoring group had a significantly lower mean HbA1c compared with the OPD group (9.1 ± 1.7% vs. 10.1 ± 2.0%; adjusted mean difference = -1.0%, 95% CI -1.6 to -0.5). Similarly, the mean fasting blood glucose was significantly lower (158.1 ± 56.0 mg/dL vs. 193.6 ± 81.0 mg/dL; adjusted mean difference = -32.1 mg/dL, 95% CI -54.5 to -9.8).
Conclusions: Homecare telemonitoring was more effective than standard OPD care in improving glycemic control among patients with uncontrolled T2DM. This approach may serve as a feasible and effective strategy for diabetes management in community and primary care settings.
Keywords: type 2 diabetes mellitus, glycemic control, telemonitoring
Downloads
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
The content and information in articles published in the PCFM journal are solely the opinions and responsibilities of the authors. The journal's editorial board does not necessarily agree with or share any responsibility for them.
All articles, information, content, images, etc., published in the PCFM journal are the copyright of the PCFM journal. If any individual or organization wishes to reproduce, distribute, or use any part or the entirety of the content, they must obtain written permission from the PCFM journal beforehand.
References
International Diabetes Federation. IDF Diabetes Atlas [Internet]. Brussels: International Diabetes Federation; 2021 [cited 2024 Jan 15]. Available from: https://diabetesatlas.org
กองโรคไม่ติดต่อ กรมควบคุมโรค. สถานการณ์โรคเบาหวานในประเทศไทย [อินเทอร์เน็ต]. นนทบุรี: กรมควบคุมโรค; 2564 [เข้าถึงเมื่อ 15 ธ.ค. 2566]. เข้าถึงได้จาก: https://ddc.moph.go.th/brc/news.php?news = 21692&deptcode = brc
วิชัย เอกพลากร, หทัยชนก พรรคเจริญ, วราภรณ์ เสถียรนพเก้า. การสำรวจสุขภาพประชาชนไทยโดยการตรวจร่างกาย ครั้งที่ 6 พ.ศ. 2562–2563. กรุงเทพฯ: สำนักพิมพ์อักษรกราฟฟิคแอนด์ดีไซน์; 2564.
สมาคมโรคเบาหวานแห่งประเทศไทย ในพระบรมราชูปถัมภ์สมเด็จพระเทพรัตนราชสุดาฯ สยามบรมราชกุมารี. แนวทางเวชปฏิบัติสำหรับโรคเบาหวาน พ.ศ. 2566. กรุงเทพฯ: ศรีเมืองการพิมพ์; 2566.
Jing X, Chen J, Dong Y, Han D, Zhao H, Wang X, et al. Related factors of quality of life of type 2 diabetes patients: a systematic review and meta-analysis. Health Qual Life Outcomes. 2018;16:189. PubMed PMID: 30231882
Phrommintikul A, Dilokthornsakul P, Permsuwan U. Economic burdens for treatment of patients with type 2 diabetes in North Thailand: a hospital-based observational study. Front Endocrinol (Lausanne). 2022;13:824545. PubMed PMID: 35651974
วีระศักดิ์ ศรินนภากรม, เปี่ยมลาภ แสงสายัณห์, มนต์ชัย ศิรบำรุงวงศ์, วิบูลย์ ภัณฑบดีกรณ์, ธัญเดช นิมมานวุฒิพงษ์, วิทูร ชินสว่างวัฒนกุล, และคณะ. แนวทางและมาตรฐานการดูแลผู้ป่วยในที่บ้าน (Home ward) [อินเทอร์เน็ต]. กรุงเทพฯ: กรมการแพทย์ กระทรวงสาธารณสุข; 2565 [เข้าถึงเมื่อ 20 ม.ค. 2566]. เข้าถึงได้จาก: https://www.dms.go.th/backend/Content/Content_File/Publication/Attach/25650805113031AM_homeward.pdf
Ghosh A, Gupta R, Misra A. Telemedicine for diabetes care in India during COVID-19 pandemic and national lockdown period: guidelines for physicians. Diabetes Metab Syndr. 2020;14:273-6.
Health Data Center, Ministry of Public Health. Percentage of diabetes patients with good glycemic control [Internet]. Bangkok: Ministry of Public Health; 2024 [cited 2024 Jan 10]. Available from: https://hdc.moph.go.th/center/public/standard-report-detail/137a726340e4dfde7bbbc5d8aeee3ac3
Saetang T. The efficacy of tele-monitoring and structured feedback loop in people with insulin-treated type 2 diabetes mellitus with suboptimal control [Master’S thesis]. Bangkok: Chulalongkorn University; 2022.
Lee JY, Chan CKY, Chua SS, Ng CJ, Paraidathathu T, Lee KKC, et al. Telemonitoring and team-based management of glycemic control in people with type 2 diabetes: a cluster-randomized controlled trial. J Gen Intern Med. 2020;35:87-94.
Jamsopon K. Effectiveness of the mobile health care service for type 2 diabetes patients during COVID-19 pandemic of primary care cluster in Kang-an community, Prasat District, Surin Province. PCFM. 2020;3:21-34.
Han CY, Zhang J, Ye XM, Lu JP, Jin HY, Xu WW, et al. Telemedicine-assisted structured self-monitoring of blood glucose in management of type 2 diabetes mellitus: results of a randomized clinical trial. BMC Med Inform Decis Mak. 2023;23:182. PubMed PMID: 37710226
National Glycohemoglobin Standardization Program. Factors that interfere with HbA1c test results [Internet]. NGSP; 2023 [cited 2024 Jan 15]. Available from: https://ngsp.org/factors.asp
Cai J, Xu H, Jiang S, Sung J, Sawhney R, Broadley S, et al. Effectiveness of telemonitoring intervention on glycaemic control in patients with type 2 diabetes mellitus: a systematic review and meta-analysis. Diabetes Res Clin Pract. 2023;201:110727. PubMed PMID: 37217016
Wild SH, Hanley J, Lewis SC, McKnight JA, McCloughan LB, Padfield PL, et al. Supported telemonitoring and glycemic control in people with type 2 diabetes: the Telescot Diabetes pragmatic multicenter randomized controlled trial. PLoS Med. 2016;13(7):e1002098. PubMed PMID: 27458809
Han J, Chen S, Wu S, Liu Y, Zhao H, Yuan J. Effectiveness of telehealth services for diabetes management in improving glycemic control and patient self-management: a systematic review and meta-analysis. J Telemed Telecare. 2023;29:135-47.
Lee CS, Tyagi S, Koh EYL, Gong PP, Ang SB, Koh CHG, Tan NC. Health outcomes of telemonitoring of patients with type 2 diabetes mellitus: one-year results from a randomized controlled trial. J Telemed Telecare. 2025;31:1249-59.
Hangaard S, Laursen HVB, Andersen JH, Andersen TO, Nørgaard K, Nielsen JS, et al. The Diabetes TeleMonitoring of patients in insulin therapy (DiaMonT) trial: effect of telemonitoring in patients with type 2 diabetes on insulin therapy. Trials. 2022;23:985. PubMed PMID: 36476605
Sacks DB, Arnold M, Bakris GL, Bruns DE, Horvath AR, Kirkman MS, et al. Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus. Clin Chem. 2011;57:e1-47. PubMed PMID: 21617152
