Background: Our institution began telemedicine clinics at rural hospitals in 2013, with standard office visits delivered synchronously via video conferencing. This project aims to assess the impact of telemedicine clinics in T1D care at our institution.
Methods: IRB approval was obtained to access records of people with T1D with three or more telemedicine visits from Nov 2013 to Oct 2019. To assess change in A1c, we used a random coefficient regression model and estimated the effect of time on A1c, controlling for gender and age at start of treatment. Data were collected on change in treatment and prior provider (PCP, outside/academic endocrinologist).
Results: The 139 patients evaluated (average age 45 y (range 16-94), 58% F) had an average of 8 A1c values (2-23) over an average duration of 32 mos (4-69). The scatterplot and fitted regression line show a temporal A1c decline. Similarly, random coefficient regression analysis provided overwhelming evidence for an A1c decline (P< 0.001). Each year in telemedicine care was associated with a decline of 0.13 in A1c (95% CI: -0.20, -0.06). Age and gender were not associated with A1c. A1c decline was noted irrespective of prior provider or treatment change (ie, starting CGM/pump therapy).
Conclusions: Our data supports the concept that T1D can be effectively managed via telemedicine. Declines in A1c were seen in all groups, irrespective of age, prior provider and additions of diabetes technology.
L.A. Eiland: None. M. Siahpush: None. P. Akkireddy: None. L. Kuechenmeister: None.
