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We developed a blood glucose management system using the Internet and short message service (SMS) which can lessen the social economic burden and materialize an individualized diabetes mellitus management. A total of 185 diabetic patients participated in this study and their mean age was 42.4 years old (8-79 year-old). Participants sent their self-measured blood glucose levels, medication and its dosages, amount of meal, and degree of exercise to their health providers in this specialized web-based diabetes management system for 3 months. The health providers consisting of endocrinology specialists, dietitians, and nurses sent recommendations for individualized diabetes management according to the data on the web. Laboratory tests including lipid profiles and glycated hemoglobin (HbA1c), and a survey of satisfaction about this system were performed before and after the study period. The mean HbA1c improved from 7.5 +/- 1.5 to 7.0 +/- 1.1% after using the management program (P = 0.003). The mean serum triglyceride and HDL-cholesterol levels turned for the better also. HbA1c improved from 8.4 +/- 1.2 to 7.5 +/- 1.0% after applying this program to patients with the HbA1c of 7% or higher at baseline (P = 0.010). We propose this web-based diabetic patient management system as a new tool for communication between health care providers and patients.

Objective: The Internet is used worldwide as a communication tool. To improve the quality of diabetes control, we investigated the effectiveness of an Internet-based blood glucose monitoring system (IBGMS) on controlling the changes in HbA(1c) levels., Research Design and Methods: We conducted a randomized clinical trial involving 110 patients who visited the outpatient clinic at the Kangnam St. Mary's Hospital for 3 months. The study subjects were treated with IBGMS for 12 weeks, and the control group received the usual outpatient management over the same period. HbA(1c) and other laboratory tests were performed twice, once at the beginning of the study and again at the end of the study., Results: The test results from the beginning of the study established that there were no significant differences between the two groups with respect to age, sex, diabetes duration, BMI, blood pressure, HbA(1c), and other laboratory data. On follow-up examination 12 weeks later, HbA(1c) levels were significantly decreased from 7.59 to 6.94% within the intervention group (P < 0.001). At the end of the study, HbA(1c) levels in the intervention group were significantly lower than in the control group after adjusting the baseline HbA(1c) (6.94 vs. 7.62%; P < 0.001, respectively). Among patients with baseline HbA(1c) <7.0%, the patients in the intervention group had lower HbA(1c) than those in the control group (6.38 vs. 6.99%; P < 0.05). Among the patients with a baseline HbA(1c) > or = 7.0%, the difference between the two groups appeared more obvious: HbA(1c) levels at the end of the study were 8.12%., Conclusions: This new IBGMS resulted in a significant reduction of HbA(1c) during the study period. We propose that this IBGMS be used as a method for improving diabetes control.