Background: Existing therapeutic interventions are well known, yet most people with diabetes do not consistently achieve blood glucose targets for optimal health, despite the large range of treatment options available.

Aim: To explore the efficacy of a novel clinical intervention addressing physical and mental health within routine consultations across healthcare settings.

Methods: A multi-centre, parallel group, individually randomised trial comparing consultation length in adults with T1D or T2D for ≥6 mths to the Spotlight Consultations platform compared to usual care. Secondary outcomes: HbA1c and validated measures of depression, diabetes distress, anxiety, functional health status and HCP burnout. Results: n=98 adults with T1D or T2D; any HbA1c and receiving any diabetes treatment participated (n=49 intervention). Consultation duration for intervention participants was reduced in intervention consultations by 0.5-4.1 mins (3-14%) versus no change in the control group (-0.9 - +1.28 mins) across 15 and 30 consultations. HbA1c improved in the intervention group by 6mmol/mol (range 0-30) versus control group 3mmol/mol (range 0-8). Moderate improvements in psychosocial outcomes observed in intervention group: functional health status; reduced anxiety, depression and diabetes distress; improved well-being. None were statistically significant. HCPs reported improved communication and greater focus in consultations. Artificial Intelligence examination highlighted therapy and psychological burden were most important in predicting HbA1c levels.

Conclusion: Spotlight-AQ was associated with shorter, more useful consultations; with improved HbA1c and moderate benefits on psychosocial outcomes. Results reflect the importance of a biopsychosocial approach to routine care visits. Spotlight-AQ is viable across healthcare settings for improved outcomes.

Disclosure

K.Barnard: Advisory Panel; Abbott Diabetes, Roche Diabetes Care, Sanofi, Consultant; LifeScan Diabetes Institute, Tandem Diabetes Care, Inc., Research Support; Novo Nordisk. R.C.Kelly: None. L.Cohen: None. E.Barnard: None. Y.Liu: None. P.Phiri: None. O.Mendez: None. H.Price: Consultant; AstraZeneca, Speaker's Bureau; Novo Nordisk, AstraZeneca, Boehringer Ingelheim and Eli Lilly Alliance.

Funding

Southern Health NHS Foundation Trust

© 2023 by the American Diabetes Association
2023
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