Can remote video visits help improve glycemic control and clinic attendance for children and adolescents with type 1 diabetes (T1D)?
Stephanie Crossen
UC Davis researchers investigated this question and recently published their findings in the journal Diabetes Technology and Therapeutics.
"This study focused on how to make care for a chronic pediatric condition like type 1 diabetes more frequent and more accessible for patients who were not achieving optimal outcomes," said Stephanie Crossen, pediatric endocrinologist at UC Davis Health and lead author of the study.
Crossen and her team supplemented quarterly in-person clinic visits with video visits for a population of pediatric T1D patients who have suboptimal glycemic control. Fifty-seven children under the age of 18 enrolled in the study. One half of participants were adolescents, and the majority lived more than 30 miles away from UC Davis Medical Center in Sacramento.
Study participants had video visits with Crossen from their homes every four, six or eight weeks, depending on their hemoglobin A1c (HbA1c) levels. Patients uploaded data from their diabetes devices before each video visit for Crossen to review.
The patients' HbA1c levels, as well as frequencies of clinic visits and diabetes-related emergency department and hospital visits, were compared before and after the study.
After one year in the study, study participants demonstrated the following outcomes:
- High patient satisfaction with the intervention (93% "very satisfied")
- Improved frequency of care (83% of participants completed four or more diabetes visits within a year, compared to only 21% prior to the study)
- Improved glycemic control (mean HbA1c decreased from 10.8 to 9.6 among participants who completed the full year)
- Increased use of diabetes technology including insulin pumps and continuous glucose monitors (CGMs)
- No significant change in diabetes-related emergency department and hospital visits
"By providing in-home telehealth visits every four to eight weeks as a supplement to the care they received at our clinic, we were able to significantly improve glucose control for 57 children and adolescents with type 1 diabetes," Crossen said. "This is a great example of how connected health technology can help us improve patient experiences and health outcomes simultaneously for people living with a chronic condition."
Other authors on the study are Nicole Glaser and James Marcin of UC Davis Health.
This research was supported by the National Center for Advancing Translational Sciences, National Institutes of Health, through grant UL1 TR001860 and linked award KL2 TR001859.
