HYBRID EVENT: You can participate in person at Boston, Massachusetts, USA or Virtually from your home or work.
Daniela Laranja Gomes Rodrigues, Speaker at Pediatric Diabetes Conferences
Hospital Alemão Oswaldo Cruz, Brazil
Title : Endocrinological teleconsultation as a strategy in the brazilian public health system: randomized clinical trial


Brazil has approximately 20 million people with Diabetes Mellitus. Early identification and treatment should be a concern of public authorities, to improve glycemic control and reduce it`s deleterious impacts on the individual's health and consequent cost reduction for health systems. Objective: present the partial results of the Teleconsulta Diabetes trial. This is a randomized clinical trial that evaluates the non-inferiority of endocrinological teleconsultation of patients with type 2 diabetes mellitus in the Brazilian public health system, compared to face-to-face consultation. Method: phase 2, single center, randomized, open study with data analyzed by an independent researcher. Inclusion criteria are adults, both sexes, ≥18 years old, glycated hemoglobin (HbA1c) ≥8%. Outcomes are hypoglycemic symptoms, laboratory, anthropometric measurements, blood pressure, adverse events, and satisfaction level after 6 months. Teleconsultation costs will be assessed using the time-driven activity-based costing method to compare the costs with the face-to-face consultations. The noninferiority margin was set at 0.5%. Assuming an SD of 1.3% for both groups, a true difference between the means of zero, and a type I error level of 5% (one-sided), it was estimated that 1at 125 individuals per group would be necessary to achieve 90% power. Statistical analysis will be done using intention-to-treat and per-protocol approaches. Results: until Dec/2021, 128 participants were included, 64 in the face-to-face group and 64 in the teleconsultation group. 54.84% are female, the mean age of 61 years. The percentage of participants by race was: 79.03% white, 10.50% black and 9.67% pardos (brown-skinned). The interim analysis of the study is scheduled for July/2022, when participant number 125 (which represents half of the sample) will complete the six months of follow-up required to complete the research. Discussion: in addition to being a model of assistance aimed at the public health system, this study covers a modality of telemedicine, teleconsultation, in which access to the specialist is made directly between the user and the doctor, increasing the capillarity of health, with the potential to have a positive impact on the outcomes of this disease. Conclusion: we expect that providing remote access to health care may result in improvements in the health outcomes and quality of life of patients with type 2 diabetes. Furthermore, it might be possible to provide healthcare rat lower costs taking both patients and clinicians to benefit from this technology. This trial is sponsored by PROADI-SUS (Programa de Apoio ao Desenvolvimento Institucional do SISTEMA Único De Saúde), from Brazilian Ministry of Health.

Audience Take Away:

  • This trial can help other physicians and health managers to create new strategies to offer specialized care to diabetic patients.
  • How will this help the audience in their job? Is this research that other faculty could use to expand their research or teaching? Does this provide a practical solution to a problem that could simplify or make a designer’s job more efficient? Will it improve the accuracy of a design, or provide new information to assist in a design problem? List all other benefits. This trial could help other researchers to develop new strategies to improve access to specialized care, especially in poor countries.


Dr. Daniela is neurologist, specialized in Cerebrovascular Diseases and Transcranial Doppler at Federal University of São Paulo. Also has a master’s degree in clinical research at Harvard T.H. Chan School of Public Health. She works as a physician and research at Hospital Alemão Oswaldo Cruz, for projects to Brazilian´s Health Ministry.