Abstract Dr. Jothydev Kesavadev, India (Speaker) Dr. Jothydev Kesavadev, M. Nayar, S. Balakrishnan, A. Shankar, S. Jothydev Jothydev's Diabetes and Research Center, Trivandrum, India, 2Nottingham University, Doncaster, United Kingdom Background: At Jothydev's Diabetes and Research Center >75% of patients enrolled and trained in a telemedicine based follow up system achieved and maintained A1c values < 7 %. Delineating major reasons of failure will provide valuable insight into remedial measures. Methods: Adults (n=400); mean age 52 with T2DM, enrolled in tele medicine follow up, DTMS (Diabetes Tele Management System) and not had at least 1 tele consult per month were tagged as non compliant. They were asked to respond to 12 point questionnaire, which included common factors hindering follow up. Results: 72% admitted being scared of reporting high sugars. 64% of patients had emotional and family issues. 76% forget to monitor and report. 56% did not realize importance of follow up despite reminding them. 48% patients admitted lack of a loving care giver. Conclusion: Repeated sessions of education by team of diabetes experts of doctors, nurses, dieticians, educators etc., directed towards patient and care givers are indispensable to ensure adherence to home glucose monitoring and tele follow up. Fear of high sugars should be specifically addressed and counseled. An educated care giver should be an active part of the diabetes team force to remind and instruct the patient on periodic monitoring and modifications in diet, drug dosages and exercise as decided by the experts