700-P: Outcomes of a Diabetes Support Coach Intervention Implemented during the COVID-19 Pandemic

Abstract

During the COVID-19 pandemic, people with diabetes reported increased diabetes distress and difficulty maintaining glycemic control. These challenges were exacerbated for racial minorities and those with low socioeconomic status. As part of a Project Extension for Community Healthcare Outcomes (ECHO) program, an intervention using 28 diabetes support coaches (DSCs), adults with diabetes who served as peer mentors and healthcare navigators, was implemented with underserved patients with type 1, type 2, and other forms of diabetes at 41 federally qualified health centers in FL and CA (intervention n=74, control n=363). Patients self-enrolled and engaged with DSCs via 1-1 weekly text messages, phone calls, or virtual meetings. Patients’ HbA1c was measured at baseline and 6-month follow-up. The Diabetes Distress Scale (DDS-17), Coronavirus Anxiety Scale (CAS-19), and a survey of diabetes technology use and COVID-19 outcomes were also administered. Descriptive statistics were computed for all metrics (n, %; median IQR for skewed data). Between-group comparisons were evaluated via Chi-Square tests for categorical data and t-tests for continuous data. Diabetes distress was significantly lower among the intervention group [DDS-17 score median=1.6] than controls [DDS-17 score median=2.1] (p=.0077). More patients in the intervention regularly used a continuous glucose monitor (CGM) (69.9% vs. controls: 38.8%, p<.001). There were no significant differences between groups in insulin pump use, HbA1c, COVID-19 anxiety, or other COVID-19 outcomes. The latter results were likely due to the COVID-19 survey evaluating structural outcomes like financial stability that were beyond the scope of the DSC intervention. Overall findings demonstrate that DSCs reduced diabetes distress and improved CGM use among underserved patients with diabetes. Support coaching is valuable for this population; further research is needed to improve their HbA1c levels and COVID-19 outcomes. Disclosure J.Maizel: None. S.C.Westen: None. K.K.Hood: Consultant; Cecelia Health. J.J.Wong: None. B.Dixon: None. S.L.Filipp: None. M.J.Gurka: None. A.F.Walker: None. M.J.Haller: Board Member; SAB Biotherapeutics, Inc., Consultant; Sanofi, MannKind Corporation. D.M.Maahs: Advisory Panel; Medtronic, LifeScan Diabetes Institute, MannKind Corporation, Consultant; Abbott, Research Support; Dexcom, Inc. A.Addala: None. R.Lal: Advisory Panel; Provention Bio, Inc., Consultant; Abbott Diabetes, Biolinq, Capillary Biomedical, Inc., Deep Valley Labs, Gluroo, Tidepool, PhysioLogic Devices, Morgan Stanley. L.Figg: None. M.Hechavarria: None. K.G.Malden: None. E.Sheehan: None. Funding The Leona M. and Harry B. Helmsley Charitable Trust (G-2005-03934)