Improving Management of Type 2 Diabetes Using Home-Based Telemonitoring: Cohort Study

Background: Diabetes is present in 10.5% of the US population and accounts for 14.3% of all office-based physician visits made by adults. Despite this established office-based approach, the disease and its adverse outcomes including glycemic control and clinical events tend to worsen over time. Avai...

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Bibliographic Details
Published in:JMIR diabetes 2021-06, Vol.6 (2), p.e24687-e24687
Main Authors: Milani, Richard, Chava, Pavan, Wilt, Jonathan, Entwisle, Jonathan, Karam, Susan, Burton, Jeffrey, Blonde, Lawrence
Format: Article
Language:English
Subjects:
Algorithms
Cohort analysis
Creatinine
Diabetes
Drug stores
Glucose
Health care
Health education
Health literacy
Hypoglycemia
Intervention
Lifestyles
Medical records
Medicine
Original Paper
Patient compliance
Questionnaires
Telemedicine
Web portals
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Summary:Background: Diabetes is present in 10.5% of the US population and accounts for 14.3% of all office-based physician visits made by adults. Despite this established office-based approach, the disease and its adverse outcomes including glycemic control and clinical events tend to worsen over time. Available home technology now provides accurate, reliable data that can be transmitted directly to the electronic medical record. Objective: This study aims to evaluate the impact of a virtual, home-based diabetes management program on clinical measures of diabetes control compared to usual care. Methods: We evaluated glycemic control and other diabetes-related measures after 1 year in 763 patients with type 2 diabetes enrolled into a home-based digital medicine diabetes program and compared them to 794 patients matched for age, sex, race, BMI, hemoglobin A1c (HbA1c), creatinine, estimated glomerular filtration rate, and insulin use in a usual care group after 1 year. Digital medicine patients completed questionnaires online, received medication management and lifestyle recommendations from a clinical pharmacist or advanced practice provider and a health coach, and were asked to submit blood glucose readings using a commercially available Bluetooth-enabled glucose meter that transmitted data directly to the electronic medical record. Results: After 1 year, usual care patients demonstrated no significant changes in HbA1c (mean 7.3, SE 1.7 to mean 7.3, SE 1.6; P=.41) or changes in the proportion of patients with HbA1c≥9.0 (n=117, 15% to n=113, 14%; P=.51). Digital medicine patients demonstrated improvements in HbA1c (mean 7.3, SE 1.5 to mean 6.9, SE 1.2; P
ISSN:2371-4379
2371-4379
DOI:10.2196/24687