Characteristics of people with type 1 diabetes who use technology in their treatment and who use frequently the technical assistance teleconsultation service

In patients with type 1 diabetes (DM1) in whom multiple dose insulin (MDI) therapy does not achieve the expected blood glucose or quality-of-life goals, the introduction of continuous subcutaneous insulin infusion (CSII) treatment under a specific structured educational programme for self-care and self-management, in addition to improving blood glucose control, is associated with a positive and lasting user experience on the part of the patients.1 The use of continuous glucose monitoring (CGM) associated with MDI or CSII (sensor-augmented pump [SAP]) has also proven to be effective and safe in these patients.2, 3 In the recently published SED 1 study, it was found that around 21% and 25% of patients with DM1 in Spain use CSII and/or CGM, respectively, as part of their treatment.4 In fact, both therapies have universal public funding throughout Spain and CGM is part of the treatment of the vast majority of patients with DM1, regardless of the insulin administration method used.5, 6, 7, 8

Manufacturers and distributors of medical devices in Spain have to comply not only with European legislation (directives and regulation), but also with the requirements set out in the Spanish Royal Decree of 2009 (RD1591/2009).9 Their obligations include having an incident surveillance system in operation, which they are responsible for managing, taking any necessary corrective measures, having a proven quality system and assigning a qualified person to liaise with the authorities who is responsible for ensuring compliance with the requirements established by legislation, regulations and Royal Decree. With medical devices used by patients (CSII, CGM and SAP, in our case), technical issues are common, and these need to be effectively resolved as quickly as possible. Such incidents are usually dealt with and resolved by the manufacturer's or distributor's technical telecare service, which provides continuous support 24 h a day, 365 days a year, and is easily accessible to both users and healthcare professionals.10 As mentioned above, recording incidents and providing an appropriate response are obligations for manufacturers and distributors of medical devices in Spain and the European Union. These records are shared with the institutions and healthcare professionals who care for people with DM1 and have enabled us to verify the great variation in how often these services are used by patients.

The aim of this study was to analyse the characteristics of the patients with DM1 who are on advanced blood glucose control therapy and use CSII or SAP who most often use the technical support telecare service, and compare them to those who use it less.

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