1317-P: Improving Access and Communication through Telehealth for Pediatric Type 1 Diabetes

Abstract

Telehealth may positively impact diabetes self-management by increasing contact between patients and providers. Our diabetes team developed a telehealth intervention to provide insulin adjustments and establish diabetes goals. Eligible youth had T1D, Medicaid insurance, and A1c 9-12%. Participants set goals at quarterly visits. Monthly, participants communicated glucose data with the healthcare team through EMR portal or via phone calls. Youth >10 years completed Diabetes Distress Scale (scores 1-6; higher=greater distress) and Diabetes Empowerment Scale (scores 1-5; higher=greater self-efficacy) at baseline, 6 mo, and 12 mo, while caregivers completed Diabetes Distress Scale for Parents (scores 1-5; higher=greater distress). Satisfaction surveys done at 3 and 12 mo (scores 1-5; higher=greater satisfaction). Baseline and 3 mo data presented. Youth (N=32, 56% male, 53% AA), aged 5-22 (12.4±3.9), with T1D for 5.1±3.5 years had baseline mean A1c 10.7±1.5%; 19% CSII and 34% CGM. At baseline, participants endorsed low levels of diabetes distress (mean score 1.9±0.9 youth and 2.1±0.6 parents). Youth endorsed high diabetes self-efficacy at baseline (mean score 4.2±0.6). There was no difference between mean A1c at baseline and 3 months (10.7% to 10.9%, N=26). Baseline A1c did not correlate with age, T1D duration, diabetes distress or empowerment for youth but correlated negatively with parental frustration [“I am the only one who takes responsibility for helping my teen manage diabetes” (r=-0.458; p=0.048) and “my teen ignores my suggestions about diabetes” (r=-0.842; p<0.009)]. Participants reported high satisfaction with the intervention (mean score 4.3±0.49). Correlation between A1c and parental frustration suggests need to improve communication between T1D teens and caretakers and enhance mental health support. Although A1c did not decline short term, families reported high satisfaction. Further research needs to assess the long-term impact of telehealth interventions. Disclosure L.E. Rasbach: None. M. Freemark: None. V. Purrington: None. M. Griffis: None. A. Annas: None. L.C. Page: None. R. Hall: None. R. Benjamin: None. Funding Duke University School of Medicine (3993054)