801-P: Effect of Adding Computerized Insulin Dose Adjustment Algorithms (CIDAA) to a Remote Patient Monitoring (RPM) Program on A1C Levels

Abstract

The purpose of this study was to determine the effect of adding CIDAA to a subpopulation of an HMO that also had an RPM program. Patients taking insulin for >6 months with A1Cs >8.0% were selected from 3 cohorts, RPM + CIDAA (Group A) , RPM alone (Group B) and usual care (Group C) and followed for 6 months. Glucose readings of Group A patients, given a Bluetooth-enabled glucometer, were analyzed with dose adjustment recommendations sent to their providers (2 MDs, 1 PA) that they could accept or modify. Health educators contacted Group A and B patients for each RPM glucose value of <70 or >200 mg/dl and counseled them how to avoid subsequent episodes. Non-insulin drugs were not allowed to be added to Group A and B patients. A1C levels were measured at baseline and 6 months. Patient demographics, their A1C responses and alerts are shown in the Table. There were no differences among baseline A1Cs but significant differences from baseline. Groups A vs. B (P = 0.01) and A vs. C (P = 0.001) were significantly different but not B vs. C. All alerts (P = 0.02) and those >200 mg/dl (P = 0.002) were significantly less in Group A vs. B but alerts <70 mg/dl were not. Conclusion: A1C levels fell twice as much without increases in hypoglycemia in poorly controlled type 2 diabetic patients taking insulin whose providers received recommendations for dose changes based on CIDAA every 2-3 weeks compared with RPM alone or usual care. Disclosure J.S.Pulicharam: None. J.Davidson: None. M.B.Davidson: Other Relationship; Mellitus Health. Funding Mellitus Health, Inc