BRIEF REPORT
Yi-Ju Chen, MD; Salim M. Saiyed, MD; Renu Joshi, MD; Anas Atrash, MD; Safi Khattab
Corresponding Author: Salim M. Saiyed, MD; Department of Family Medicine, Telehealth UPMC Central Pa.
Email: drsalimsaiyed@gmail.com
DOI: 10.3122/jabfm.2024.240216R1
Keywords: Diabetes Mellitus, Electronic Health Records, Glycemic Control, Patient Education, Primary Health Care, Telemedicine
Dates: Submitted: 06-01-2024; Revised: 11-23-2024; Accepted: 12-09-2024
Status: In production for ahead of print.
BACKGROUND: Telemedicine can improve access between physicians and patients and improve outcomes when deployed strategically in patients with chronic diseases. Telemedicine not only showed success in the care of chronic diseases, but its application also expanded exponentially during the COVID-19 pandemic. At our institution, a 12-week telemedicine diabetes “boot camp” was launched for patients with uncontrolled diabetes as an innovative means of providing accessible and high-quality patient care in primary care settings.
METHODS: Patients at primary care and endocrinology clinics with diabetes mellitus (DM) and glycosylated hemoglobin (A1C) > 8.0% were voluntarily enrolled from September 2020 to November 2021. Dietitians and diabetes care and education specialists conducted bi-weekly visits via telemedicine for twelve weeks. Patient demographics, A1C, body mass index (BMI), and blood pressure were measured before and after the intervention.
RESULTS: A total of 134 patients were included, and ninety-four patients (70.2%) completed six visits for the full twelve-week program. The mean A1C reduction was –2.09% ± 2.4%, and the A1C change was uniform across age groups, gender, ethnicity, BMI, and referral clinic type. A greater A1C reduction in patients who completed all six visits was noted although not statistically significant. We found a negative correlation between the initial A1C and the change of A1C. No significant BMI or mean arterial pressure change was observed.
CONCLUSION: This single arm study demonstrated an improvement in A1C for all patients with a history of poorly controlled diabetes, regardless of patient characteristics. Higher initial A1C was associated with a greater A1C reduction.