Diabetes-related distress affects a significant proportion of adults with type 2 diabetes (T2D) and is associated with poor glycemic control and more problematic self-management. The Onduo Virtual Diabetes Clinic (VDC) is a telehealth program for people with T2D that combines mobile App technology, remote personalized lifestyle coaching, connected BG meters, real-time continuous glucose monitoring (rtCGM) devices and clinical support from board-certified endocrinologists.
This exploratory analysis evaluated change in diabetes distress among 228 program participants who reported moderate distress (score 2.0-2.9) or severe distress (score ≥3.0) on the diabetes distress scale (DDS17) at enrollment. Change in diabetes-related distress was also compared for rtCGM vs. non-rtCGM user groups. Participants were age 51.8±9.5 years, 73.2% female and 39.5% were on insulin. During program participation, 94.7% used a connected BG meter and 33.8%, deemed to be high risk, used rtCGM intermittently. Participants reported significant reductions in overall DDS17 score, from 3.0±0.8 at baseline to 2.5± 0.9 (p<0.001) at an average of 6 months follow-up. Significant reductions in all DDS subscale scores were observed; most notable were reductions in the regimen-related and emotional distress subscales (-0.9 and -0.4, respectively; both p<0.001). Diabetes-related distress improved significantly in both CGM and non-rtCGM users. However, greater reductions in overall DDS17 score, -0.7 ± 0.8 vs. -0.4±0.9 (p=0.012), and regimen-related distress, -1.3±1.2 vs. -0.7±1.3 (p<0.001), were reported by participants who were prescribed and used intermittent rtCGM (n=77) vs. non-users (n=151).
These findings suggest that the VDC program, which includes ongoing individualized lifestyle, clinical support and use of connected devices, may be an effective approach to support individuals with T2D and clinically relevant diabetes distress.
W.H. Polonsky: Advisory Panel; Self; Intarcia Therapeutics, Roche Diabetes Care. Consultant; Self; Abbott, Dexcom, Inc., Eli Lilly and Company, Insulet Corporation, Novo Nordisk Inc., Onduo, Sanofi US, Xeris Pharmaceuticals, Inc. J.E. Layne: Employee; Self; Onduo. C.G. Parkin: Consultant; Self; Abbott, CeQur Corporation, Dexcom, Inc., DreaMed Diabetes, Novo Nordisk Inc., Onduo, Roche Diabetes Care, Valeritas, Inc. C. Kusiak: Employee; Self; Verily Life Sciences LLC. Stock/Shareholder; Self; Verily Life Sciences LLC. N.A. Barleen: Employee; Self; Onduo. D.P. Miller: Employee; Self; Verily Life Sciences LLC. Stock/Shareholder; Self; Verily Life Sciences LLC. H. Zisser: Employee; Self; Verily Life Sciences LLC. Stock/Shareholder; Self; Verily Life Sciences LLC. R.F. Dixon: Employee; Self; Onduo.