An original research carried out at Jothydev’s Diabetes Research Centre, Trivandrum, followed up 414 compliant patients with diabetes over a period of 19 years. The results of this long-term follow-up study were presented at the American Diabetes Association’s 78thScientific Convention at Orlando, USA, on June 24, 2018. These 414 subjects were adherent to Diabetes Tele-Management system (DTMS®) developed at Jothydev’s Diabetes Research Centre. In addition to 1-2 hospital visits per year, these patients were on a regular and periodic virtual follow up via the internet or telephone. The dosage of drugs, diet modifications, exercise advices, troubleshooting on glucose monitoring and drug administration were carried out through these periodic virtual consultations. The study after the end of 19 years demonstrated that vascular complications in the eye, kidney, nerves and in the blood vessels were successfully averted in 93.5% of the subjects which is in sharp contrast to mere 3-5% in the general population.

New-onset Chronic Kidney Disease (CKD) appeared in only 0.24% of the study population; New-onset Coronary Artery Disease (CAD) /Cerebrovascular Accident (CVA) appeared in only 2.4% of the study population, and Deaths occurred in only 3.86% of the study population. On the contrary, kidney disease, heart attacks and strokes are very common complications in the general population affecting 30-80% of people with diabetes.

The study population had significant improvements in average blood glucose (-0.68%), LDL i.e. bad cholesterol (-60.3 mg/dl), blood pressure SBP/DBP (-7.2/-8.66 mmHg) and creatinine (0.04 mg/dl) levels which stabilised in the initial 1-5 years and were maintained thereafter throughout the study period. This real-world study from India in type 2 diabetes patients being followed up for 19 years through a telemedicine protocol, is the largest from Asia and has demonstrated statistically significant and clinically meaningful results.

The detailed design and interim findings were earlier published in several indexed medical journals. Diabetes Tele Management System (DTMS®) involving timely therapeutic and lifestyle modifications have been delivered by Dr. Jothydev Kesavadev, Dr. Arun Shankar, Ms. Gopika Krishnan, Dr. Lakshmy Ramachandran, Ms. Sunitha Jothydev and a team of more than 15 trained diabetes care professionals.

List of presentations at ADA:

1. IDegAsp Improves Glycemic Control with Minimal Hypoglycemia—An Indian Real-World Study in T2D Subjects. Jothydev Kesavadev, Banshi D. Saboo, Arun Shankar, Ashwin David, Rohit Warrier, Gopika Krishnan, Lakshmy Ramachandran, Sunitha Jothydev. Diabetes Jul 2018, 67 (Supplement 1) 389-P; DOI: 10.2337/db18-389-P.

2. Are Complications Preventable with Periodic Education via Telemedicine? A Study of 414 Compliant T2D Patients Followed Up for 19 Years. Jothydev Kesavadev, Arun Shankar, Ashwin David, Gopika Krishnan, Neethu A. Ajai, Geethu Sanal, Jaysree Ajith, Soumya Jayanthi, Lakshmy Ramachandran, Sunitha Jothydev. Diabetes Jul 2018, 67 (Supplement 1) 685-P; DOI: 10.2337/db18-685-P.

3. Enabling Data-Driven Decision Making for Personalized Care in Type 2 Diabetes with Clinical and Lifestyle Journey Data Using a Digital Therapeutic. Rajeev Chawla, Maaz Shaikh, Abhishek Shah, Banshi D. Saboo, Brij M. Makkar, Jothydev Kesavadev, Shilpa Joshi, Neeta Deshpande, Sanjay Agarwal, Anuj Maheshwari, Aravind R. Sosale, Sv Madhu. Diabetes Jul 2018, 67 (Supplement 1) 248-OR; DOI: 10.2337/db18-248-OR.

4.Efficacy of a Basal-Plus Regimen. Banshi D.J. Saboo, Dhruvi Hasnani, Hardik Chandarana, Sudhir Bhandari, Shashank Joshi, Jothydev Kesavadev, Anuj Maheshwari, Hemant Thacker. Diabetes Jul 2018, 67 (Supplement 1) 2292-PUB; DOI: 10.2337/db18-2292-PUB.

5. Conversational Artificial Intelligence for Achieving Activity Targets through Routine Physical Activity—Longitudinal Observational Study among People with Type 2 Diabetes. Brij M. Makkar, Maaz Shaikh, Abhishek Shah, Shilpa Joshi, Banshi D. Saboo, Aravind R. Sosale, Sv Madhu, Rajiv Kovil, Tejas Shah, Manoj S. Chawla, Rajeev Chawla, Jothydev Kesavadev. Diabetes Jul 2018, 67 (Supplement 1) 750-P; DOI: 10.2337/db18-750-P.

6. One-Year Safety and Effectiveness of Insulin Degludec in Patients with Diabetes Mellitus in Routine Clinical Practice in India—TRUST (Tresiba Real-World Use Study). Jothydev Kesavadev, L. Sreenivasa Murthy, Banshi D. Saboo, Sadasiva Rao Yalamanchi, Balamurugan Ramanathan, Sunil Gupta, Sanjay Chatterjee, Manjunatha Revanna, Harsha Kasetty. Diabetes Jul 2018, 67 (Supplement 1) 1019-P; DOI: 10.2337/db18-1019-P.

7. Continuous Glucose Monitoring Guided Assessment of Concentrated U200 r-DNA Human Premix 30/70 Insulin. Hemant Thacker, Jothydev Kesavadev, Gursimran Singh, Kirti Shukla, Gaurav Puppalwar, Rupal Shrimanker. Diabetes Jul 2018, 67 (Supplement 1) 1013-P; DOI: 10.2337/db18-1013-P.