L'avenir de l'autosurveillance glycémique chez le diabétique de type 1 passera-t-il par la télémédecine et la télésurveillance ?

Blood glucose determination must be central in the management of type 1 diabetes. Current self-monitoring of blood glucose systems have not much evolved conceptually for over 30 years. Smartphones have become powerful and affordable enough to allow a renewal of SMBG offer, by strengthening metabolic efficiency, therapeutic safety, patient satisfaction, and care trackability. New electronic glycemic diaries should feature algorithms designed for automatic insulin dose determination, allowing help for real time decision. These meters should communicate, with health care professionals through Internet, and with insulin delivery systems (pump or pen), allowing telemonitoring. Availability of mobile expert systems able to predict future glycemic values is awaited, as well as free and meter-independent softwares dedicated to SMBG data analysis and insulin titration help. Manufacturers are expected to take into account results of clinical trials, ergonomic requirements and health care system reimbursement constraints.