Program completion and glycemic control in a remote patient monitoring program for diabetes management: Does gender matter?

• Published in: Diabetes research and clinical practice 2020-01, Vol.159, p.107944-107944, Article 107944
• Main Authors: Michaud, Tzeyu L., Siahpush, Mohammad, King, Keyonna M., Ramos, Athena K., Robbins, Regina E., Schwab, Robert J., Clarke, Martina A., Su, Dejun
• Format: Article
• Language: English
• Subjects: Diabetes Mellitus, Type 2 - therapy; Engagement; Female; Gender disparities; Gender Identity; Glycated Hemoglobin A - analysis; Glycated Hemoglobin A - metabolism; HbA1c; Humans; Male; Middle Aged; Monitoring, Physiologic - methods; Program participation; Retrospective Studies; Telemedicine; Telemedicine - methods; Type 2 diabetes
• ISSN: 0168-8227; 1872-8227
• DOI: 10.1016/j.diabres.2019.107944

•Women with T2D were more likely to complete the diabetes management program via RPM.•Men had a better glycemic outcome than women among those who completed the program.•Personalized diabetes care targeting women’s diabetes outcomes and men’s engagement level is warranted. To examine gender differences in program completion and glycemic outcomes for patients with type 2 diabetes (T2D) in a remote patient monitoring (RPM) program for diabetes management. Based on data from an RPM program that enrolled post-discharge T2D patients (n = 1645) in 2014–2017, logistic regression models were estimated to assess gender difference in the likelihood of completing the three-month RPM program; whereas ordinary least squares (OLS) regression models were used to examine gender difference in post-RPM hemoglobin A1c (HbA1c), controlling for demographics, baseline health status, including HbA1c, patient activation scores, and physiological data upload frequency for patients who had completed the program. Among enrolled participants, men had lower odds of completing the three-month RPM program than women (adjusted odds ratio, 0.61; 95% confidence interval [CI], 0.39–0.95). However, among those who completed the program, men had lower post-RPM HbA1c than women (−0.18; 95% CI, −0.33, −0.03) after controlling for baseline HbA1c and other covariates. While female patients with T2D were more likely to complete the RPM program, they showed a higher glycemic level at the end of the program compared to male patients. To close gender disparities in health, interventions through telemedicine tailored towards women’s diabetes outcomes and men’s engagement level are warranted.