Type 1 diabetes is an autoimmune disease that results in the body’s inability to produce insulin, necessitating lifelong daily insulin treatment. Managing the disease involves a high level of self-care and a thorough understanding of both the condition and its treatment to effectively control blood sugar levels. Chronic high blood sugar levels, known as hyperglycemia, present an ongoing challenge for individuals with type 1 diabetes, leading to an elevated risk of developing cardiovascular disease and a decreased life expectancy.

Advancements in diabetes technology over the past decade have led to increased availability and use of advanced medical equipment. Continuous glucose monitors allow for real-time glucose measurement and alerts for glucose levels, while advanced insulin pumps can help regulate insulin delivery based on data from glucose monitors and mathematical algorithms, leading to improved glycemic control. Data from the Norwegian Diabetes Register for Adults indicates an overall improvement in glycemic control, yet 60% of Norwegian type 1 diabetes patients still fail to meet glucose treatment targets. 

There has been a growing emphasis on preventive measures to reduce the risk of cardiovascular disease, diabetes, and kidney disease among individuals with type 1 diabetes. Mental and emotional strain are common among those living with and managing diabetes. The term «diabetes distress» refers to such diabetes-related concerns. Addressing these psychological aspects of diabetes care is crucial for overall well-being and successful management of the disease.

Our current study investigates the potential benefits of user-controlled home follow-up utilizing a digital tool with a traffic light model. Specifically, we are examining whether this intervention can enhance glycemic control, promote adherence to preventive drug regimens for cardiovascular and kidney conditions, decrease diabetes-related distress, impact healthcare utilization and self-care, and improve overall quality of life. At present, there is limited scientific evidence supporting this interventional approach. The digital tool will gather data from patients’ glucose monitors and insulin pumps every four months, utilizing a traffic light system to categorize patients into «red», «yellow», or «green» pre-defined values. Patients flagged as «red» will promptly receive contact from a diabetes nurse within 48-72 hours, while those marked as «green» are deemed not to require immediate attention.  Additionally, patients will be required to complete a validated questionnaire to assess diabetes distress every four months, with results informing diabetes nurse. Moreover, patients will have the option to contact the diabetes outpatient clinic through the digital tool to schedule appointments as needed.

The Medical Department at Drammen Hospital has secured funding for the research project «User-controlled remote monitoring in patients with type 1 diabetes; effects on metabolic control, health-care utilization, distress, and self-care behavior». This collaborative project involves all four Vestre Viken hospitals, AHUS, Ålesund Hospital, and UNN-Harstad, as well as the Norwegian Diabetes Register for Adults. AHUS, Ålesund Hospital, and UNN-Harstad have already included type 1 diabetes patients in digital home follow-up. Vestre Viken hospitals are set to begin user-controlled digital home follow-up in January/February 2024 . The goal is to include at least 2000 patients with type 1 diabetes across the participating hospitals.

The project is led by postdoctoral researcher Stina Therese Sollid, with PhD candidate Ine Solesvik Oppedal working on the project.