Refereed papers A real-time, mobile phone-based telemedicine system to support youngadultswithtype1diabetes Andrew Farmer FRCGP Senior Research Fellow, Department of Primary Health Care Oliver Gibson MEng Doctoral Student, Department of Engineering Science Paul Hayton DPhil Post-doctoral Research Fellow, Department of Engineering Science Kathryn Bryden RGN Research Nurse, Department of Primary Health Care UniversityofOxford,UK Christina Dudley RGN Research Nurse Andrew Neil FRCP Professor and Honorary Consultant Physician Oxford Centre for Diabetes, Endocrinology and Metabolism, Oxford, UK Lionel Tarassenko FREng Professor of Engineering Science, Department of Engineering Science, University of Oxford, UK ABSTRACT Telemedicine systems have been proposed as a means of supporting people with diabetes in the self-management of their condition. Requirements for monitoring parameters of care, including glycaemic control, extent of analysis and interpret- ation of data, patient–clinician contacts, and in- volvement of a multidisciplinary care team with effective communication, can be addressed by telemedicinesystems.Wedescribethedevelopment and implementation of an innovative real-time telemedicine system based around transmission and feedback of data to and from a mobile phone. Proprietary Java-based programs were used to link a blood glucose meter to a mobile phone. In addition to immediate transmission of blood glucose data, information about insulin dose, eating pat- terns and physical exercise were collected. Immediate feedback to the phone included a colour histogram todrawattentiontolevelsofcontroloverglycaemia over the previous two weeks. Clinicians supporting patients had access to summary screens identifying users not testing, and those with levels of blood glucose outside pre-defined limits. More detailed graphical displays of data were used to provide data about control of insulin dose and the degree to which it was modified in response to diet and exercise. The system has been evaluated in a clinical trial conducted in secondary care and is now being adapted for use in a trial in primary care, which is designed to assess its effectiveness in providing integrated management for the patient, general practitioner and pharmacist. Keywords: diabetes, medical care, monitoring Informatics in Primary Care 2005;13:171–7 # 2005 PHCSG, British Computer Society