1132-P: Understanding Patients New to Insulin—Baseline Evaluation of Participants in the “Implementation and Testing of a Diabetes Discharge Intervention to Improve Safety during Transitions of Care” Study

Objective: Describe baseline patient characteristics, needs, and stress of new to insulin at hospital discharge.

Methods: Single site RCT to evaluate a DM Discharge Toolkit on mean 30-day glucose is ongoing among English speaking patients (pts), 21 - 80 years, with expected survival > 90 days, new to insulin at discharge.

Results: Among 97 eligible, 67 approached, and 40 enrolled (consent rate 60%). Mean age was 51.9 years +11.4; 55% were male; 35% had public insurance; 52% identified as black, 30% white, and >22% Hispanic/Latino, with 23 (58%) prior DM. Mean glucose was 374 <u>+</u>213 and median HbA1C 11.4 [9.6, 13.3]. Nearly 30% had limited literacy (Single Item Literacy Screener, >2), though > 90% had home internet and reported its use for health information. Acceptability of research continuous glucose meter (CGM) at discharge was high (48%). Stress was also high, over 60% reported elevated perceived stress (Perceived Stress Scale <u>></u>14), 35% with prior DM reported elevated DM distress (Diabetes Distress Score <u>> </u>2.0). A majority (60%) had <u>></u> 1 health-related social need (HRSN), 12.5% had > 3; food insecurity (22.5%), transportation (15%) and medication affordability (12.5%) were highest.

Conclusion: Our medically/socially complex cohort of DM patients consented to RCT, including many of minority race/ethnicity. These patients have high levels of disease and non-disease specific stress and multiple HRSN that could affect safe insulin delivery. Interestingly, most accessed and used technology/internet, and were open to DM technology (CGM). Achieving better glycemic control in our sickest patients demands comprehensive, multi-modal interventions which can leverage DM technology to enhance care delivery.