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Telemedicine and diabetes: State of the art and prospects in Haiti

Jeeph SERGILLES

Telemedicine (TM) should address several major challenges: to improve access to healthcare, to overcome the scarcity of specialists faced with epidemic disease,and to reduce the costs of healthcare while improving quality. The aims of TM differ according to the type of diabetes. In type1 diabetes (T1D), the goal of TM is to help patients achieve better control of their blood glucose (BG) levels through accurate adjustment of insulin doses. In type 2 diabetes (T2D), while therapeutic adjustments may be necessary, improvement in BG control is based primarily on behavioral changes. Many telemedicine studies focusing on management of BG levels have been published, but most failed to demonstrate any superiority of TM vs. traditionalcare.While previously published meta-analyses have shown a slight advantage at best for TM,these meta-analyses included a mixture of studies of varying lengths, in different populations, testing systems of unequal quality.