Glycemic Outcomes of Endocrinology Consultation for Type 2 Diabetes by Visit Modality: A Retrospective Cohort Study
Authors' conclusion
e-Consult and audio-only telemedicine for initial endocrinology consultations were associated with inferior 6-month glycemic outcomes compared with in-person care among adults with uncontrolled type 2 diabetes, and video telemedicine had similar glycemic outcomes. e-Consult and audio-only telemedicine care protocols may need to incorporate additional support for patients to achieve glycemic outcomes equivalent to in-person consultation.
Study context
- Population
- Adults with T2D and HbA1c ≥8% seen for initial outpatient endocrinology consultation, 31 January 2021 to 1 April 2023, Veterans Health Administration; 93.1% men, mean age 64 years, 54.7% White
- Participants
- 21,847 adults
- Exposure
- e-Consult and synchronous telemedicine vs in-person initial endocrinology consultation
- e-Consultn = 5,180
- Synchronous telemedicinen = 4,377
- In personn = 12,290reference
- Outcome
- HbA1c <8% (64 mmol/mol)
- Follow-up
- 6 months
Methodological detailsmixed-effects logistic regression, adjusted for patient-level variables
- Mixed-effects logistic regression
- Adjusted for patient-level variables
Main finding
As reported in the abstract
HbA1c <8%
Each group vs in personAdjusted odds ratio (95% CI)
e-Consult
0.77(0.71–0.83)
Synchronous telemedicine
0.86(0.80–0.93)
- Achieved 6-month HbA1c <8%, overall
- 49.5%
Observational data: associations, not effects.
Further findings
| Outcome | aOR (95% CI) | |
|---|---|---|
| HbA1c <8%, audio-only telemedicine (sensitivity analysis) · 6 monthsAudio-only telemedicinevs In personSensitivity analysis | 0.78 (0.71–0.86) | |
| HbA1c <8%, video-based telemedicine (sensitivity analysis) · 6 monthsVideo-based telemedicinevs In personSensitivity analysis | 0.98 (0.88–1.09) | |
| 0.512Adjusted odds ratio (log scale) |
Associations of patient-level characteristics with glycemic outcomes across modalities
- No significant differences across care modalities
Original publication
Glycemic Outcomes of Endocrinology Consultation for Type 2 Diabetes by Visit Modality: A Retrospective Cohort Study. Diabetes Care. Published 17 April 2026. doi:10.
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