Telehealth Boosts Visit Frequency Among Type 1 Diabetes Patients

February 21, 2023 - Recent research published in the Journal of Diabetes Science and Technology found that telehealth increased clinic attendance while lowering physician-related distress among adolescents and young adults (AYAs) with type 1 diabetes (T1D).

According to the Centers for Disease Control and Prevention (CDC), 28.7 percent of people of all ages, that is, 8.7 percent of the US population, had been diagnosed with diabetes in 2019. In the same year, 283,000 people younger than 20 had been diagnosed with diabetes, 244,000 of whom had T1D.

For many young adults, managing T1D is difficult due to physiological and psychosocial challenges, as well as growing independence at that age, the study noted.

This led researchers to examine the effects of a virtual care model on the treatment of T1D. They conducted a 15-month study that evaluated an adaptation of the Colorado Young Adults with T1D (CoYoT1) Care model, which includes person-centered care, virtual peer groups, and physician training occurring through telehealth.

The researchers recruited adolescents and young adults aged 16 to 25 years with T1D for at least six months to participate in the study. Of the 80 patients recruited, 68 completed the baseline surveys provided and necessary assessments. The 68 patients were assigned to receive care through the CoYoT1 model or standard care, delivered via telehealth or in-person. Researchers noted that the end of the study took place during the COVID-19 pandemic, because of which all participants transitioned to telehealth appointments.

The main measures for the study were clinic attendance, physician-related distress, HbA1c, and device use among patients who participated in over half of their diabetes clinic visits through telehealth and those who attended appointments in person.

Of the 68 patients in the study population, 39 (57 percent) attended more than half of their visits through telehealth. This subset of the population completed more diabetes care visits compared to those who primarily participated in in-person visits, with 3.3 visits completed among the former compared to 2.5 visits among the latter.

Researchers also found that those who used telehealth more often reported little change in physician-related distress, while those who attended more in-person visits reported increases in physician-related distress over the course of the study. 

Further, while device use did not significantly change over the study period, those in the CoYoT1 group primarily receiving care via telehealth reported significant reductions in HbA1c compared to those receiving standard care who mostly attended in-person visits.

Based on these findings, researchers concluded that higher telehealth use, specifically through a person-centered care model, led to improvements in adolescent and young adult care for T1D, along with higher clinic attendance rates and lower physician-related distress levels.

This is not the first study to show the positive impact telehealth use has on diabetes care outcomes.

Research published in June 2022 found that higher telehealth and continuous glucose monitor (CGM) use resulted in various benefits for pediatric T1D patients, such as lower hospitalization frequency, improved glycemic control, and lower depression incidence.

During the COVID-19 pandemic, many patients of various demographics faced difficulty obtaining in-person care. Thus, researchers sought to determine the effect of the pandemic on patients with T1D, examining various patient factors before and after the public health emergency began.

Overall, they found little differences in factors like glycemic control, hospitalization, and PHQ-9 depression screening between pre- and post-pandemic periods. This finding led them to surmise that increased telehealth and CGM use supported T1D care during the pandemic.