1321-P: Lower Use of Technology in Youth with Type 1 Diabetes in Locations Distant from Specialty Care

Abstract

Pediatric patients with type 1 diabetes (T1D) who live far from a diabetes specialty clinic have fewer clinical visits. Telemedicine can increase visit frequency, but the impact on adoption of diabetes technology, such as insulin pumps and continuous glucose monitoring (CGM), is unclear. Pediatric patients with T1D in Colorado and Wyoming who received diabetes care from our center via telemedicine were eligible to participate. As part of an ongoing telemedicine study, medical records were reviewed to ascertain technology use, and data were compared to patients whose care did not involve the use of telemedicine. Patients (N=149, age 12.0 ± 4.3 yrs, T1D duration 2.7± 4.2 yrs, HbA1c 8.9 ± 1.8%, gender 60% male, race/ethnicity 74% non-Hispanic white, insurance status 68% private) who utilized telemedicine between 2012 and 2019 were included. Compared to the general clinic (N=2672), technology use was lower (pump: 64% vs. 77%, p = 0.001; CGM: 35% vs. 79%, p <0.001; pump and CGM: 30% vs. 56%, p <0.001). Use of technology among telemedicine patients was not associated with gender, T1D duration, insurance or distance from the main clinic but was associated with race/ethnicity and lower HbA1c (Table). Diabetes technology use is lower in pediatric T1D patients using telemedicine. Additional research is needed to explore potential reasons for this discrepancy and methods to improve the use of diabetes technology in these patients. Disclosure E.C. Cobry: None. T. Reznick-Lipina: None. L. Pyle: None. R.H. Slover: None. J.F. Thomas: None. G.T. Alonso: None. R. Wadwa: Advisory Panel; Self; Eli Lilly and Company, Medtronic. Research Support; Self; Dexcom, Inc., Eli Lilly and Company, MannKind Corporation, Medtronic, Novo Nordisk Inc., Tandem Diabetes Care. Funding National Institutes of Health (K12DK094712); National Center for Research Resources (UL1TR002535)