Trial improves diabetes care with eHealth tool

A new research initiative — the Australian Diabetes Clinical Trial Network (ADCTN) — aims to increase the number of clinical trials for diabetes.

Established by Diabetes Australia and the Australian Centre for Accelerating Diabetes Innovation (ACADI), the initiative will support diabetes researchers by providing expert review and feedback for clinical trial protocols and grant funding applications.

Diabetes Australia Group CEO Justine Cain said clinical trials are a cornerstone of medical research and innovation because of their real-world application.

“Clinical trials ensure that new treatments deliver real benefits to people, while also identifying any potential risks or side effects.

“Our new network will increase the number of diabetes clinical trials being funded and conducted in Australia. This will make a huge difference in the lives of people living with diabetes because it means new and innovative treatments and interventions can be tested and hopefully become available.”

ACADI director and head of Medicine at Melbourne University Professor Elif Ekinci said, “By advancing our understanding of how different treatments work and evaluating their impact, clinical trials play a crucial role in improving the care of people living with diabetes. Their results contribute to the development of more effective, safer healthcare options and help inform evidence-based practices in medicine.”

The REMODeL trial

Princess Alexandra Hospital’s REMODeL research team leader, endocrinologist Dr Anish Menon, is leading a clinical trial where advances in technology and online access to health practitioners are improving outcomes for patients with complex type 2 diabetes.

The Rethinking Models of Outpatient Diabetes Care Using eHealth (REMODeL) trial enables patients to record and upload their blood glucose readings using a Bluetooth glucose meter and receive automated feedback based on parameters set on a clinician dashboard app. Clinicians review results in real time via a “smart alert” triaging feature that helps identify patients who need priority support. The REMODeL trial received funding from ACADI.

“Imagine a world where managing diabetes is made easier by checking your phone!” Menon said.

“That’s the future REMODeL is creating. This innovative nurse-led model of care using digital tools is empowering people with type 2 diabetes, letting them track their health stats and share that info with their nurses in real time. No more waiting for appointments or worrying about missed calls — it’s like having a diabetes expert in your pocket!”

Menon said the additional benefit is that clinicians get more time to focus on what matters most: providing complex (high-value) care.

Since the REMODeL research began in 2016, participants have achieved an average 1% reduction in HbA1c (average glucose levels over two to three months), which translates into reductions of 21% in diabetes-related deaths, 14% myocardial infarctions (heart attacks), and 37% of microvascular complications (affecting kidneys, eyes, lower limbs etc). There are also reduced in-person clinic visits rather than the traditional care model.

The research team has successfully demonstrated that these benefits can also be experienced by people from regional areas to improve quality of life and decrease diabetes distress. The current plan is to explore this model of care in disadvantaged and CALD populations.

A personalised approach

Director of Diabetes and Endocrinology at the Princess Alexandra Hospital Dr Lisa Hayes said REMODeL’s personalised approach supports better health outcomes with greater ease and precision, marking a significant step forward in diabetes care.

“We’re hoping that remote funding could be provided in the near future, which would mean that this will become routine care for people attending diabetes clinics,” Hayes said.

“Our findings show that through changes to the way we care for people with diabetes, we can improve their outcomes.

“REMODeL findings have the potential to change the health and life expectancy for Australians with diabetes wherever they live.

“If more people living with type 2 diabetes had access to continuous glucose monitoring devices, we could make this even more efficient and effective,” she said.

Image credit: iStock.com/Alena Butusava