October 18, 2018

 Ioanna A. Anastasiou, Ourania A. Kosta, Anastasios N. Tendolouris, Ioanna Eleftheriadou, Nikolaos Tendolouris

Diabetes Center, 1st Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece

Effective management of blood glucose levels is essential for the prevention of microvascular and macrovascular complications among individuals with diabetes mellitus. Therefore, healthcare providers need an easy way to access real-time accurate blood glucose data. The iGlucose® Cellular Diabetes Care Solution by Smart Meter LLC is a convenient and affordable way to  automatically send blood glucose readings via text message or email to the person with diabetes, their family members, physicians and others in their circle of care.

Principal Aim

The aim of this report is to share information about the iGlucose Solution based on clinician experience, as well as patients’ observations after 3 months of use. iGlucose was registered to sixty-six participants with diabetes mellitus from May 2018 till September 2018. We recruited in the study 25 adult females and 41 males; 10% of the participants had type 1 diabetes and 90% type 2 diabetes.

The Clinician Benefits

Time savings is an essential parameter for the clinician.  With iGlucose, the clinicians saw significant improvements in diabetes management. We had access to our patients’ results prior to the scheduled visit which was very helpful. In addition, patients were not able to make excuses about forgetting their test results or report false measurements. The automatic recording of the testing results provided us a complete glycemic profile of our patients.  All physicians involved in the study felt the quality of the patient interaction and patient visits improved significantly using iGlucose. Furthermore, the real-time access in each patient’s account, after permission, was a great advantage to achieve euglycemia. We had the opportunity to review our patients’ data between the scheduled visits and intervene, if needed. More than 80% of our patients required intervention between visits. There were non-compliant patients that we reached via telephone to remind them to keep up with their glucose testing or to advise them that the range of their measurements was too high or too low. Taking the real-time data that iGlucose was providing under consideration, we were able to give advice and guide our newly diagnosed patients on how to adjust their therapy.

Other benefits that came out of this study was the ability to personalize the quantity of strips that were given to each patient, based on their testing frequency reducing our costs and our patients’. There was always encouragement for more testing. Moreover, the blood glucose measurement reminders of the device straight to the patients’ email or mobile phone was considered a huge advantage; patients who measured blood glucose levels more frequently had better glycemic control.

We recommended every patient who participated in our study to continue to use iGlucose. Effort is needed to convince patients to be more compliant in measuring their blood glucose levels and we saw iGlucose as a solution that helped significantly.

The Patient Benefits

Most of the patients that took part in this study did not have previous experience with meters that shared data. This was a challenge since we had to explain to them the advantages of sharing their measurement data. Many of our patients write down their test results in a notebook they carry with them to every scheduled visit. Having this procedure done automatically by iGlucose was a good experience and made them feel more comfortable.

Initially when we gave the meter to our patients, they had some minor problems with the unique top insertion of the strips in the meter. After our detailed instructions, 90% of our patients found using the meter very easy. Additionally, they reported that the usability of iGlucose was easy to learn.

Our patients found the coaching texts not particularly helpful.  They believed that they could test as suggested without the need for reminders. On the other hand, they found the opportunity to have their loved ones involved getting texts with their results was very helpful, especially for particular groups of people living with diabetes such as children and elderly people.

There has been a significant improvement in the interaction between clinicians and patients with the use of iGlucose. 60-70% of our patients felt the quality of patient interaction and patient visits improved using iGlucose. Participants were positive about not writing their measurements down and having to remember bringing their logbook along with them to their office visits. Furthermore, the fact that they had a clear and detailed view of their glucose range between each visit made them feel safer. Moreover, 90% patients felt comforted knowing their clinicians were viewing the data. Most of our patients (about 80%) also reported they felt they had more control over their diabetes management using iGlucose. As a result, we noticed better measurement compliance and therefore, better glycemic control. Moreover, the blood glucose measurement reminders of the device straight to the patients’ email or mobile phone is considered a huge advantage; 90% patients who measure blood glucose levels after 3 months had a reduction to their average blood glucose level by 30%.

Furthermore, the patient also saw a cost savings with iGlucose. By personalizing the quantity of strips that were given to each patient based on the frequency of their measuring their glucose level, the amount of controlled strip utilization reduced patients’ costs by almost 50%.

In summary, 67% of our patients wanted to continue to use iGlucose in the future. Of the remaining 33%, if the device was in their native language, 20% of them would have wanted to continue use.

 The Study Conclusion

Overall, we found the iGlucose Cellular Diabetes Care Solution to be a valuable addition in managing our patients with diabetes. Having complete, accurate and timely patient BG results gives us the information we need to make the best decisions for our patients’ care. Our patients found iGlucose easy to use and liked knowing more about their blood glucose trends. They saw the improvement in the quality of their office visits when everyone was working together seeing the same information.

We’re looking forward to continuing using iGlucose at the University of Athens.

Correspondence:
1st Department of Propaedeutic Internal Medicine,Laiko General Hospital, 17th Agiou Thoma Str., 11527 Athens
Secretariat: Tel. : 0030 213-2061061, Fax: 0030 213-2061794,
E-mail: ntentol@med.uoa.gr