7-PUB: Student-Led Initiative Addressing Health Care Gaps in South Carolina Free Medical Clinics

Introduction & Objective: Diabetes is a leading cause of death in South Carolina and disproportionally affects those of lower socioeconomic status. Medical Students Making Change (MSMC) is an initiative at the University of South Carolina that aims to improve lifestyle management and glycemic control in uninsured patients with diabetes. Via an innovative telehealth approach, this project provides patients guidance to address and identify health disparities affecting their chronic condition. We hypothesize that this intervention will significantly reduce hemoglobin A1c and improve patient confidence in managing their diabetes over a six-month period.

Methods: Patients with newly diagnosed or uncontrolled diabetes in two free medical clinics are paired with a medical student volunteer who follows them over the course of six months with biweekly telephone visits. Visits primarily focus on diabetic education, lifestyle goals, and barriers to care. Hemoglobin A1cs are obtained at enrollment, three months, and six months.

Results: Patient screening began in August 2023 and was performed regardless medical history of diabetes. Currently, 46 patients have been screened: 14 patients are enrolled with a baseline A1c of 10.3; 15 patients are not enrolled despite A1c values >6.5%; and 16 patients did not meet A1c requirements for enrollment. Patient barriers most identified included food insecurity, exercise ability, and lack of transportation.

Conclusion: Our initiative promotes longitudinal relationships allowing patients the education and resources needed to manage their diabetes. From our pilot study, we gained resources to increase monitoring for appropriate follow up A1cs and increase screening among all clinic patients regardless of medical history of diabetes. As the current results highlight the need for increased diabetic screening, the goal of this project is to make a significant impact on diabetes outcomes and reduce healthcare barriers for this vulnerable population.