Patterns of Telemedicine Use and Glycemic Outcomes of Endocrinology Care for Patients With Type 2 Diabetes
Authors' conclusion
In this cohort study of adults with T2D receiving endocrinology care, patients using telemedicine alone had inferior glycemic outcomes compared with patients who used in-person or mixed care. Additional strategies may be needed to support adults with T2D who rely on telemedicine alone to access endocrinology care, especially for those with complex treatment or elevated HbA1c.
Study context
- Population
- Adults with T2D who had a telemedicine endocrinology visit May–October 2020, followed through May 2022of 11,498 potentially eligible
- Participants
- 3,778 adults
- Exposure
- Telemedicine-only vs in-person vs mixed endocrinology care
- Telemedicine onlyn = 1,182
- In-personn = 1,049
- Mixed caren = 1,547
- Outcome
- Adjusted HbA1c change within each cohort
- Follow-up
- 12 months
Methodological detailssingle large integrated US health system, multivariable regression
- Single large integrated US health system
- Multivariable regression
Main finding
As reported in the abstract
Adjusted HbA1c change within cohort
| Group | Value | P |
|---|---|---|
| Telemedicine only | −0.06% (95% CI −0.26%–0.14%) | P = .55 |
| In-person | 0.37% (95% CI 0.15%–0.59%) | P < .001 |
| Mixed care | 0.22% (95% CI 0.07%–0.38%) | P = .004 |
Value
Telemedicine only−0.06% (95% CI −0.26%–0.14%)
In-person0.37% (95% CI 0.15%–0.59%)
Mixed care0.22% (95% CI 0.07%–0.38%)
P
Telemedicine onlyP = .55
In-personP < .001
Mixed careP = .004
Observational data: associations, not effects.
Further findings
| Outcome | Difference (95% CI) | P value | |
|---|---|---|---|
| 12-month HbA1c change, MDIvs no insulinHigher with telemedicine | 0.25% (0.02%–0.47%) | P = 0.03 | |
| −0.200.20.40.6Difference (linear scale) |
Subgroup with baseline hemoglobin A1c (HbA1c) ≥8%
- Similar pattern of glycemic outcomes
Comorbidities and HbA1c change
- Comorbidities not associated with HbA1c change in any cohort
Original publication
Patterns of Telemedicine Use and Glycemic Outcomes of Endocrinology Care for Patients With Type 2 Diabetes. JAMA Netw Open. Published 1 December 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →