Glycemic outcomes and patient satisfaction and self-management improves in transition from standard to virtual multidisciplinary care

Noga Minsky, Liat Arnon Klug, Tatyana Kolobov, Elizabeth Tarshish, Yuval Shalev Many, Aviva Lipsitz, Amna Jabarin, Nicole Morozov, Dania Halperin, Moshe Shalom, Rachel Nissanholtz-Gannot, Genya Aharon-Hananel, Amir Tirosh, Orly Tamir

Research output: Contribution to journalArticlepeer-review

Abstract

Aims: With advances in cloud-based technologies, there has been a rise in remote T1D care. We hypothesized that transitioning T1DM care to a virtual, multidisciplinary clinic could improve measures beyond HbA1c. Methods: To assess the impact of transitioning from standard to virtual T1DM care, we evaluated glycemic measures and patient reported outcomes. Results: Sixty-one adults with T1DM were included, with mean age 40.2 ± 13.5 years and diabetes duration 16.9 ± 9.0 years. Most patients were treated with insulin pumps and CGM. The number of annual diabetes care encounters rose from 2.1 ± 4.2 to 12.8 ± 5.5. Baseline HbA1c was 7.9 ± 1.6 %(63 ± 16.9 mmol/mol), declining to 7.3 ± 1.1 %(56 ± 8.5 mmol/mol) and 7.1 ± 1.0 %(54 ± 7.7 mmol/mol) at 6 and 12 months respectively (p < 0.001 for both). In parallel, TIR improved from 63.1 ± 19.3 % to 69.2 ± 13.8 % (p < 0.001) and 67.5 ± 19.4 % (p = 0.03) at 6 and 12 months respectively, while TBR declined. Scores from validated diabetes treatment and self-management questionnaires rose significantly and these rises were associated with a reduction in HbA1c, the latter score was also associated with increased TIR. There was a trend toward a correlation between encounter frequency and improvement in HbA1c and TIR. Conclusions: Transitioning from standard to virtual, coordinated, multidisciplinary T1DM care is associated with increased visit frequency, improving glycemic control, treatment satisfaction and self-care behaviors.

Original languageEnglish
Article number111587
JournalDiabetes Research and Clinical Practice
Volume209
DOIs
StatePublished - Mar 2024
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2024 Elsevier B.V.

Funding

This work is supported by the European Foundation for the Study of Diabetes in collaboration with Sanofi S.A.[EFSD/Sanofi European Pilot Research Grant for Innovative Measurement of Diabetes Outcomes Programme, 2019] and the Israel Ministry of Health Telemedicine Grant [3-000-18089, 2021]. We would like to thank Professor Mordechai Shani, virtual diabetes clinic providers, past and present, our partners in the Israeli Ministry of Defense Rehabilitation Department and in Maccabi Health Services in Northern Israel.

FundersFunder number
European Foundation
Israel Ministry of Health Telemedicine3-000-18089
Israeli Ministry of Defense Rehabilitation Department
Maccabi Health Services in Northern Israel

    Keywords

    • HbA1c
    • Patient Reported Outcome Measures (PROMs)
    • Telediabetes
    • Telemedicine
    • Time in Range (TIR)
    • Type 1 Diabetes Mellitus (T1D)

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