1831-PUB: Improving Accessibility of Patients with Type 1 Diabetes to Treatment by a Diabetes Nurse Practitioner

Abstract

Background: Treatment of type 1 diabetes (T1D) is complex, requires therapeutic intensity and understanding patient needs. The COVID-19 pandemic has led to a rapid and dramatic increase in the use of telemedicine to maintain treatment continuum and response to patients. Dedicated software, developed to transfer data from patients’ glucose sensors and insulin pumps to the treating team, facilitates personalized therapeutic interventions. Diabetes Nurse Practitioners (DNPs) have the knowledge, treatment skills and expertise for analyzing patient data transferred by the software; hence, they are an essential resource for managing diabetes treatment in these patients. The lack of suitable infrastructure and staff members who specialize in T1D has led to the establishment of a dedicated DNP unit within a diabetes clinic in Israel. The unit’s services are provided by frontal and telemedicine sessions to patients aged 18-40 with T1D. Its aims include continuous and regular monitoring of patients, achieving glycemic control according to patients’ personal targets, and preventing acute and late complications. The DNP provides comprehensive advice and training, assesses, and evaluates the patients' conditions, adjusts their therapy and refers them to appropriate care providers based on their medical and emotional conditions. Each session lasts 30-45 minutes. The summary of each session is sent to the diabetes doctor and to the primary clinic’s team. Methods: Analysis of patient data treated by the dedicated DPN unit between January and July 2022. Results: A total of 143 patients underwent 537 sessions; 55% were frontal visits and 44.4% were telemedicine visits (online or by phone). improved glycosylated hemoglobin was noted in 61% of patients. One patient was hospitalized. Conclusions: DNPs are an important factor for improving the quality of care of patients with T1D by providing personalized care, continuous contact and better access to services through remote consultation. Disclosure O.Waizinger: None.