Telemedicine for Adolescents With Insulin-dependent Diabetes

Study Group Study group will be asked to test blood glucose at least 4 times a day Each time
the study subject takes a meter reading the meter time-stamps the reading. All meter readings
will upload to the cloud via" Myglucohealth" website, where they can be accessed by
caregivers, including providers and parents. Device will be programmed to coax patients when
readings are due. Parents will be notified by device about the blood glucose testing results.
Provider will set device to alert patient or patient's family if patient has not yet tested
or uploaded a test or send alerts to parent if uploaded numbers are outside an identified
range (<70 mg/dL > 300 mg/dL). As per the standard of care, parents are trained to administer
sugar containing liquids, or inject extra insulin for hyperglycemia correction. Parents will
be encouraged to contact study personnel if they are concerned about the diabetes control.
Study personnel will access home blood glucose monitor data, and provide insulin dosing
advice. Parents will be asked to upload blood glucose readings prior to each visit.

Control group Subjects will continue routine care which requires blood glucose testing at
least 4 times a day. Parents will use customary ways to communicate (pager, email, fax or
phone) with the Diabetes team, if they are concerned about glycemic control..

Study group will have two virtual visits (months 3 and 6) Control group will have all
quarterly visits in person. A laptop will be used for virtual visits and will be set up with
the help of the TTUHSC Information Technology Security Officer.

Inclusion Criteria:

-- Age 10-18 years

- Multiple daily injections regimen

- Duration of diabetes > 12 months

- HbA1c > 7%

- Lives outside of Lubbock

- Committed to visit schedule

Exclusion Criteria:

- Foster care or residential facility

- Psychiatric illness

- Developmental delay

- Reading at < 4th grade level

- Pregnancy

- Known seizure disorder