Background Diabetes mellitus represents a continuously evolving health emergency, with 4 million patients in Italy and 9.2 billion euros of direct costs per year for the National Health Service, to which another 10.8 billion euros in indirect costs must be added. In recent years, new technologies have been developed for the management of insulin-treated diabetes mellitus. The study evaluated the metabolic outcome in a group of outpatients with type 1 diabetes mellitus (T1DM) and patients with insulin-dependent type 2 diabetes mellitus (T2DM) in health care residences (RSA). Materials and methods The study compared glycemic compensation data before and after an observation period through tele monitoring associated with cloud-based teleconsultation. Patients used continuous glucose monitoring (CGM) or flash glucose monitoring (FGM) sensors. Personalized alarms of the devices warn the patient in case of hypoglycemia or hyperglycemia, promoting better daily glycemic control. Access to the platform was guaranteed to both patients and the diabetes team. The diabetologist, through remote data analysis, used messages, calls and/or video calls, for therapeutic adjustments or educational advice. Results For patients with T1DM, telemonitoring has allowed more accurate and timely glycemic control, reducing the frequency of outpatient visits and improving autonomy in managing the disease. In elderly patients with insulin-dependent T2DM in RSA, telemonitoring has proven to be a crucial tool for optimizing insulin therapy, reducing episodes of hypo- and hyperglycemia. Conclusions Telemonitoring for improving glycemic control has proven to be an innovative and effective tool useful for improving diabetes management, optimizing the use of healthcare resources and enhancing patients' quality of life. Its implementation represents an important step towards a more personalized and sustainable approach to diabetes care.

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Key words: Diabetes mellitus, continuous glucose monitoring (CGM), flash glucose monitoring (FGM), tele monitoring, cloud-based teleconsultation