265-OR: Effectiveness of a Virtual Diabetes Clinic in a Racially Diverse Population Free

Objective: To evaluate the outcome of a novel virtual diabetes clinic on glycemic control in a diverse group of patients with type 2 diabetes.

Methods: 86 patients completed a medical questionnaire, which generates recommendations based on clinical algorithms. All participants had at least one physician consult and unlimited access to a virtual care team (RDs, RN, and PharmD). Participants self-identify race, insurance status, prior conditions and medications. HbA1c levels were documented when joining the program (patient-reported from prior lab or an initial result obtained as part of the program). Subsequent HbA1c results were measured through the lab program (dried blood spot or in-home phlebotomy) or were confirmed results from a non-integrated lab. We compared the first and last HbA1c levels using a paired t-test. In addition, we evaluated the percentage of participants whose HbA1c levels were lowered to target (from >7% to ≤7%).

Results: Participants were highly diverse, with 45.4% self-identifying as non-white. During the study period, 21 of 86 participants received at least one new generic medication or dose adjustment. Among the 24 patients (27.9%) with an initial HbA1c >8%, there was a significant improvement in HbA1c (mean decline 1.7, from 9.5% to 7.8%, p<0.01). Upon joining the program, 39 (45%) participants had an HbA1c >7%; at the end of the study period (ave. 148 days), only 24 (27.9%) had an HbA1c >7% (p=0.018, X²-test).

Conclusions: Participation in a virtual diabetes clinic improved HbA1c significantly over a 3-6 month period in a racially and ethnically diverse population. Prospective studies are needed to confirm the initial effectiveness of a virtual clinic for diabetes over longer periods. Approximately 50% of program members are uninsured and pay an affordable monthly fee. This initial effectiveness suggests that affordable cash-pay virtual clinic solutions may be an efficient and convenient option for patients with diabetes who experience barriers to accessing traditional care.