1138-P: INNOVATIONS—Improving Care of Patients with Type 1 Diabetes Mellitus through Utilization of Telemedicine and Outreach—Twelve-Month Outcomes

Abstract

Despite advances in diabetes treatment options, many youth fail to meet glucose targets and remain at risk of developing complications. Additional diabetes support in the form of telehealth may help youth meet diabetes related goals. Eligible youth had insulin dependent diabetes, Medicaid insurance, were ages 8-18, and willing to use a continuous glucose monitor (CGM). The quality improvement project provided weekly check-ins with a diabetes educator and monthly video visits with a nurse practitioner. Participants also received visit reminder calls. We measured A1c at quarterly clinic visits and tracked ED/hospitalization rates. 12-month data presented. Youth (N=26, 65% female, 88% NHB), aged 8-18 yr, diabetes duration 6.3±4.3 years, 23% were on insulin pumps. There was a significant difference between baseline A1c (mean 12.3%) at 6 months (mean A1c 11.2%) (p=0.02) and at 9 months (mean A1c 11.2%) (p=0.02). There was no significant difference in hospitalization rates during the 12-month intervention. There was no difference in visit adherence at 3, 6, 9, or 12 months during the intervention compared to those times prior. Participants were wearing CGM significantly more 3 months into the intervention compared to 3 months prior (p=0.008). Although not statistically significant, more participants were using CGM consistently at 6, 9 and 12-month time points compared to prior. 27% of participants started insulin pumps during the intervention. An intensive telehealth intervention provided interim improvement in glycemic control. Although not statistically significant, more participants used CGM consistently during the intervention, which could have clinical significance over time. Efforts to improve the durability of technology use and glycemic control warrant exploration. Disclosure L.E.Rasbach: None. V.C.Purrington: None. D.Adkins: None. R.Benjamin: None. Funding Innovation Health Grant (2933476)