Abstract
Background: Telehealth has been shown to be effective in the management of chronic disease. We describe our experience using Telehealth for patients wearing insulin pump or continuous glucose monitor (CGM). Methods: In Sep 2019, a weekly VA video connect clinic (Diabetes VVC) was started for patients on insulin pump or CGM. The clinic is staffed by a registered dietitian, who is a certified diabetes educator and insulin pump trainer. Patients are seen in the telehealth clinic between face-to-face visits with endocrinologist. In these video visits, CGM and pump downloads were reviewed, and specialized diabetes education provided. Sometimes changes in management are suggested after discussion with endocrinologist. In this retrospective study, several metrics were evaluated: travel distance, type of diabetes, type of insulin pump or CGM, medications, weight, height, BMI, time in rage 70-180mg/dL (when CGM was in use) and recommendations. We also assessed [U1] the number of interactions (visits) with the diabetes team. Results: 34 patients participated in the VVC leading to 85 encounters. Most of them were males, 88% (30/30). The majority were on CGM alone (25/34) and remaining on CGM and insulin pump (9/34). Their A1c before the first VVC encounter was 8.7% +/-1.5. About 21/34 patients requested additional follow up via VVC appointments, leading to an average of 2.33 encounters during the 3 months study period. Distance travelled one way for face-to-face visit was estimated to be 74.2 miles +/-37.4. Changes in diabetes care was recommended for insulin dosing in 22% (19/85) of encounters. Adjustments in CGM/pump settings recommended in 18% (16/85) of encounters. Overall there were meaningful changes made to diabetes care in 41% of encounters. Conclusions: The use of telehealth for diabetes care resulted in significant changes in diabetes therapy in a sizeable number of patients and saves time and travel distance. A telehealth clinic supports and enhances patient preference and experience. Disclosure M. Amole: None. L. Whyte: None. H. Ghayee: None. J.A. Leey: None.
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