Aim: To understand how remote Certified Diabetes Care and Education Specialists (CDCES) helped adults with type 1 diabetes (T1D) transition from provider in-person to tele-visits.

Methods: Adults with T1D were referred to remote CDCES to fulfill needs from 4/16/2020 - 8/14/2020. Pertinent information from the EMR was provided to the CDCES who were not previously known to the patients. A summary of the remote CDCES encounter was communicated to the provider. Data analysis used t-tests to assess differences in means and Pearson correlation coefficients to assess relationship between the number of encounters and insurance and age. SPSS v. 27 was used.

Results: Adults (n=1089) with T1D [mean age 46 (range 18-90 yrs); 50% female; 20% Medicaid, 23% Medicare, 54% private coverage; mean A1c 8.4% (range 4.6 to >14.0%); 52% pump and 61% CGM users], had 1662 encounters with remote CDCES. Of those referred, 232 (21%) could not be reached or did not receive education/support. Older age was associated with more encounters (r=0.126, p<0.001) as was coverage with Medicare (mean 1.9) vs. private insurance (mean 1.3; p<0.001) vs. Medicaid (mean 1.6; NS). A1c was negatively correlated with age (r=-0.195, p<0.001). During remote encounters the most frequently discussed topics were CGM (64%), insulin pumps (48%), tele-visit preparation (37%) and hypoglycemia (24%); device download training (46%) and CGM education/data review (58%) was provided to participants. Lack of access to a computer, tablet, smartphone or internet was seen in 14%; mean age of those without vs. with access was 51 vs. 45 yrs (p<0.001).

Conclusions: Most remote CDCES encounters in adults with T1D were successfully completed, assisting the majority with CGM education/data review and nearly half with device download training in preparation for their provider tele-visit. Older adults and those with Medicare required more encounters to fulfill needs. Future study could assess whether remote encounters result in improved glycemic control or quality of life.

Disclosure

M. Greenfield: None. D. L. Stuber: None. D. Stegman-barber: None. K. Kemmis: None. B. A. Wells: None. T. S. Mcarthur: None. B. Matthews: None. C. P. Morley: None. R. S. Weinstock: Research Support; Self; Boehringer Ingelheim International GmbH, Diasome Pharmaceuticals, Inc., Eli Lilly and Company, Insulet Corporation, Kowa Research Institute, Inc., Medtronic, Tolerion, Inc.

Funding

The Leona M. and Harry B. Helmsley Charitable Trust; T1D Exchange QI Learning Collaborative

© 2021 by the American Diabetes Association
2021
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