BACKGROUND
Telemedicine and messaging with a diabetes care team can overcome geographic barriers to specialized care for diabetes patients living in under-resourced areas, and enable more frequent clinical interactions, which have been shown to reduce the time needed to achieve HbA1c <7.0%. Carbon Health created a novel multidisciplinary diabetes care model that harnesses the strengths of these interventions and delivers care that is as data-driven and personalized as it is collaborative and person-centered.
OBJECTIVE
To examine the clinical efficacy of a virtual diabetes care model integrating remote continuous glucose monitoring and multi-disciplinary care.
METHODS
We performed a retrospective chart review of patients with type 1 diabetes (T1D) and type 2 diabetes (T2D) in Carbon Health’s diabetes program with a baseline HbA1c on file. Primary outcome measures include change in HbA1c and long-term time in range (%LTIR), long-term time below range (%LTBR), and Glucose Management Indicator (GMI), calculated from aggregated CGM data since the first week time in range >70% was achieved. Exploratory measures included change in weight and change in Problem Areas in Diabetes (PAID) survey scores. Patients were asked to complete a questionnaire assessing their satisfaction.
RESULTS
A total of 230 patients (36.1% with T1D; 45.6% taking insulin; median baseline HbA1c 8.0%) were included. Over a median follow-up of 38 weeks, patients across all baseline HbA1c categories saw HbA1c reductions, up to -4.3% in patients with baseline HbA1c ≥9.0%. Patients with baseline HbA1c ≥7.0% maintained a median (IQR) GMI 6.8% (6.4 to 7.3%), %LTIR 82.3% (66.3 to 94.9%), and %LTBR 0.4% (0.1 to 1.3%) on long-term data. Improvements in PAID score and weight in patients with overweight/obesity were seen. Of 51 survey respondents, all expressed satisfaction with the program.
CONCLUSIONS
These findings suggest our virtual integrated diabetes program helps patients with T1D and T2D achieve and maintain clinical glycemic targets. Benefits were accompanied by improvements in diabetes self-management, diabetes-related distress, and weight in overweight individuals.
CLINICALTRIAL
Not applicable