Comprehensive Telehealth Model to Support Diabetes Self-Management
Authors' conclusion
Results from this cohort study demonstrated clinical benefits associated with implementation of a comprehensive care model that included diabetes education. This model of care has potential to reach a large portion of patients with diabetes, facilitate diabetes technology adoption, and improve glucose control.
Study context
- Population
- Adults with T1D or T2D referred through community resources, US; mean age 47 years, 53% female, median diabetes duration 20 years
- Participants
- 234 adults
- Exposure
- T1D vs T2D
- T1Dn = 160
- T2Dn = 74
- Outcome
- Continuous glucose monitoring (CGM)-measured mean glucose, CV, TIR 70–180 mg/dL, time >180 or >250 mg/dL, time <70 or <54 mg/dL; HbA1c at baseline, 12 and 24 weeks
Methodological detailssingle-arm, remote, virtual, Conducted virtually August 24, 2020, to May 26, 2022
- Single-arm
- Remote
- Virtual
- Conducted virtually August 24, 2020, to May 26, 2022
Main finding
As reported in the abstract
HbA1c change from baseline · 6 months
| Group | Value | Baseline hemoglobin A1c (HbA1c), mean (SD) | 3-month HbA1c, mean (SD) | Mean change baseline to 6 months (95% CI; P) | Mean time in range (TIR) increase over 6 months (95% CI; P) | TIR increase over 6 months (95% CI; P) |
|---|---|---|---|---|---|---|
| T1D | mean 7.1 (SD 1.0%) % | 7.8% (1.6%) | 7.1% (1.0%) | −0.6% (−0.8% to −0.5%; P < .001) | 11% (9% to 14%; P < .001) | |
| T2D | mean 7.1 (SD 0.9%) % | 8.1% (1.7%) | 7.1% (1.0%) | −1.0% (−1.4% to −0.7%; P < .001) | 18% (13% to 24%; P < .001) |
Value
T1Dmean 7.1 (SD 1.0%) %
T2Dmean 7.1 (SD 0.9%) %
Baseline hemoglobin A1c (HbA1c), mean (SD)
T1D7.8% (1.6%)
T2D8.1% (1.7%)
3-month HbA1c, mean (SD)
T1D7.1% (1.0%)
T2D7.1% (1.0%)
Mean change baseline to 6 months (95% CI; P)
T1D−0.6% (−0.8% to −0.5%; P < .001)
T2D−1.0% (−1.4% to −0.7%; P < .001)
Mean time in range (TIR) increase over 6 months (95% CI; P)
T1D11% (9% to 14%; P < .001)
T2D— not stated in the abstract
TIR increase over 6 months (95% CI; P)
T1D— not stated in the abstract
T2D18% (13% to 24%; P < .001)
Observational data: associations, not effects.
Further findings
Median
| Outcome | T1D | T2D |
|---|---|---|
| CGM use over 6 months | 96% (IQR 91%–98%) | 94% (IQR 85%–97%) |
Safety
| Outcome | T1D | T2D |
|---|---|---|
| Hypoglycaemia (time <70 and <54 mg/dL) · 6 months | ||
| Mean decrease in time <70 mg/dL (95% CI; P) | 0.8% (−1.2% to −0.4%; P = .001) | — not stated in the abstract |
| Mean decrease in time <54 mg/dL (95% CI; P) | 0.3% (−0.5% to −0.2%, P < .001) | — not stated in the abstract |
| Time <70 mg/dL, mean (SD) | — not stated in the abstract | 0.5% (0.6%) |
| Time <54 mg/dL, mean (SD) | — not stated in the abstract | 0.07% (0.14%) |
— not stated in the abstract
Hypoglycaemia (time <70 and <54 mg/dL) · 6 months
- In T2D, hypoglycaemia was rare
Original publication
Comprehensive Telehealth Model to Support Diabetes Self-Management. JAMA Netw Open. Published 2 October 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →