Design, methods, and evaluation directions of a multi-access service for the management of diabetes mellitus patients

Riccardo Bellazzi, Marco Arcelloni, Giuliana Bensa, Hannes Blankenfeld, Eulàlia Brugués, Ewart Carson, Claudio Cobelli, Derek Cramp, Giuseppe D'Annunzio, Pasquale De Cata, Alberto De Leiva, Tibor Deutsch, Pietro Fratino, Carmine Gazzaruso, Angel Garcìa, Tamás Gergely, Enrique Gómez, Fiona Harvey, Pietro Ferrari, Elena HernandoMaged Kamel Boulos, Cristiana Larizza, Hans Ludekke, Alberto Maran, Gianluca Nucci, Cristina Pennati, Stefano Ramat, Abdul Roudsari, Mercedes Rigla, Mario Stefanelli

Research output: Contribution to journalArticlepeer-review

60 Citations (Scopus)


Recent advances in information and communication technology allow the design and testing of new models of diabetes management, which are able to provide assistance to patients regardless of their distance from the health care providers. The M2DM project, funded by the European Commission, has the specific aim to investigate the potential of novel telemedicine services in diabetes management. A multi-access system based on the integration of Web access, telephone access through interactive voice response systems, and the use of palmtops and smart modems for data downloading has been implemented. The system is based on a technological platform that allows a tight integration between the access modalities through a middle layer called the multi-access organizer. Particular attention has been devoted to the design of the evaluation scheme for the system: A randomized controlled study has been defined, with clinical, organizational, economic, usability, and users' satisfaction outcomes. The evaluation of the system started in January 2002. The system is currently used by 67 patients and seven health care providers in five medical centers across Europe. After 6 months of usage of the system no major technical problems have been encountered, and the majority of patients are using the Web and data downloading modalities with a satisfactory frequency. From a clinical viewpoint, the hemoglobin A1c (HbA1c) of both active patients and controls decreased, and the variance of HbA1c in active patients is significantly lower than the control ones. The M2DM system allows for the implementation of an easy-to-use, user-tailored telemedicine system for diabetes management. The first clinical results are encouraging and seem to substantiate the hypothesis of its clinical effectiveness.

Original languageEnglish
Pages (from-to)621-9
Number of pages9
JournalDiabetes Technology & Therapeutics
Issue number4
Publication statusPublished - 5 Jul 2004


  • Diabetes Mellitus
  • European Union
  • Humans
  • Internet
  • Research Design
  • Telemedicine


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