919-P: Trends in Glycemic Control during the COVID-Pandemic in a Large Academic Health Care System

Abstract

The Emory Diabetes Management Program is a chronic care management model aimed to reduce the proportion (%) of adult patients with HbA1c >9% within the Emory Healthcare System. We report the proportion of patients with poor glycemic control (HbA1c >9% or missing values for 6 months) before and during the Covid-pandemic, from 02/01/18 to 10/30/2021.Among 27,061 patients with diabetes before COVID-pandemic, the % of patients with poor glycemic control decreased from 19.5% to 14.35% in 12/2019. During the COVID-pandemic, the % of patients with poor control rapidly increase to 21.70% (Fig 1A) by 2/1/21, primarily due to a 275% increased of patients with missing HbA1c testing and a minor increase in % of patients with HbA1c >9% (Fig 1B) . Expansion of telemedicine programs, access to care and resource implementation to identify and facilitate HbA1c testing reduced the % of patients with poor control to pre-pandemic levels. Conclusion: At a population-health level, COVID-pandemic had a significant negative impact in % of patients with poor control primarily due to HbA1c testing (3-fold increase) rather than worsening A1c values. Innovative solutions to increase access to A1C testing in future pandemics may help to maintain undisrupted glucose monitoring and control in individuals with diabetes in large academic health systems. Disclosure G.E.Umpierrez: Research Support; AstraZeneca, Dexcom, Inc., Novo Nordisk. A.Adiga: None. B.Wylde: None. M.Gurtu: None. R.J.Galindo: Advisory Panel; Sanofi, WW International, Inc., Research Support; Dexcom, Inc., Eli Lilly and Company, Novo Nordisk. T.Thompson: None. C.M.Masi: None. P.A.Castellano: None. F.E.Turton: None.