Effectiveness of video consultations in type 1 diabetes patients treated with insulin pumps in the outpatient clinic: a randomised controlled trial

TL;DR

A study found that video consultations for type 1 diabetes patients using insulin pumps did not significantly improve blood sugar control but improved treatment satisfaction.

Contribution

This is the first randomized controlled trial evaluating the effectiveness of video consultations for type 1 diabetes patients using insulin pumps.

Findings

Video consultations showed no significant improvement in time in range (TiR) compared to physical consultations.

Patients in the video consultation group reported higher treatment satisfaction and lower HbA1c levels.

Video consultations had a negative impact on quality of life compared to in-person visits.

Abstract

The aim of this work was to assess the effect of video consultations over 1 year compared with usual care for patients with type 1 diabetes treated with insulin pumps, with time in range (TiR) as the primary outcome measure.

We carried out a 52 week, open label, randomised, controlled superiority trial including adult type 1 diabetes patients treated with insulin pumps. Participants were recruited from the Hospital of Southern Jutland and were adult patients, diagnosed with type 1 diabetes mellitus who had used an insulin pump for at least 6 months. Participants were randomised to video consultations (intervention) or physical consultations (control) using a computer-generated block randomisation sequence in a 1:1 allocation, stratified for sensor type (continuous glucose monitor and flash glucose monitor, respectively).Since this was an ‘open-label’ trial, neither the healthcare professionals providing the treatment nor the participants were blinded to allocation after randomisation. The primary outcome measure was the percentage of TiR (glucose levels 3.9–10.0 mmol/l) from week 51 to 52, measured by continuous glucose monitoring. Continuous endpoints were analysed using ANCOVA, with randomised treatment and stratification groups as fixed effects and the baseline value as a covariate. Missing data in the intention-to-treat (ITT) population were addressed using multiple imputation.

Of the 76 randomised participants (ITT population, 38 per group, median age 49 years, 51% women), 32 participants in the intervention group and 31 in the control group completed the study. Least square means TiR at 1 year was 64.3% in the video group and 63.5% in the control group, with a clinically insignificant difference of 0.8 percentage points (95% CI −5.3, 6.9; p=0.25). For secondary outcomes, the video group was superior in terms of treatment satisfaction and reduction in HbA1c. However, the video group experienced an inferior impact on quality of life.

Video consultations did not significantly improve the primary endpoint. However, compared with control, the intervention was associated with superior treatment satisfaction and a favourable effect on HbA1c, albeit with an inferior impact on quality of life.

ClinicalTrials.gov NCT04612933

The study received funding from Knud and Edith Eriksens Mindefond. The Section for Biostatistics and Evidence-Based Research, the Parker Institute, Bispebjerg and Frederiksberg Hospital is supported by a core grant from the Oak Foundation.

The online version of this article contains peer-reviewed but unedited supplementary material available at 10.1007/s00125-025-06585-2.

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