Abstract
Frequent diabetes support and glucose review via telehealth may help decrease hospitalization rates and improve glycemic control for high-risk youth. This support may also help with uptake and durability of diabetes technology. Eligible youth had insulin dependent diabetes, Medicaid insurance, ages 8-18, and willing to use a continuous glucose monitor (CGM) . The quality improvement project provided weekly check-ins with a diabetes educator, visit reminders, and monthly video visits with a nurse practitioner. 10-item Likert questionnaire (1=not at all comfortable; 5=very comfortable) given at baseline assessed diabetes related comprehension. A needs assessment evaluated a family’s interest in learning about certain areas of diabetes management. A1c was done at quarterly clinic visits and ED/hospitalization rates tracked. 3 month data presented. Youth (N=29, 62% female, 79% NHB) , aged 8-18 yr, diabetes duration 6.3±4.3 years, had baseline mean A1c 12.3±1.7%; 28% on CSII. Mean baseline score of diabetes comprehension was 4.0±0.6. Baseline A1c correlated negatively with diabetes comprehension (r=-0.40, p<0.05) . There was no difference between A1c at baseline and at 3 months (p=0.14) and no differences in ED/hospitalization rates compared to 2 years prior when controlled for time. There was an increase in CGM use from 3 months prior to the intervention (36% of participants) to 3 months after baseline (64%) , though this was not statistically significant (p=0.09) . There was no difference in clinic visit adherence at 3 months despite reminders. Preliminary data reveal that those patients with the highest HbA1c often have the lowest comprehension regarding optimal diabetes care, and may benefit from education reinforcement. CGM use increased with greater understanding of this technology, and may become clinically significant over time. Further research is needed to assess the long-term impact of telehealth interventions. Disclosure L.E.Rasbach: None. V.Purrington: None. D.Adkins: None. R.Benjamin: None. Funding Innovation Health (2933476)
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