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Examining a Diabetes Self-Management Education and Support Telemedicine Model With High-Risk Patients in a Rural

Linda Siminerio1, Jodi Krall2, Patricia Johnson2

  • 1Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.

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Summary

A virtual diabetes support program (TREAT-ON) effectively reduced HbA1c in rural patients with type 2 diabetes. This telehealth model proved well-received and comparable to in-person education, offering a viable solution for underserved populations.

Keywords:
diabetes educationself-managementtelemedicinetype 2 diabetes

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Area of Science:

  • Endocrinology
  • Digital Health
  • Health Services Research

Background:

  • Ongoing support is crucial for diabetes self-management education and support (DSMES) effectiveness.
  • Resource-limited areas face challenges in providing consistent DSMES.
  • This study evaluated a virtual support model for high-risk type 2 diabetes patients in a rural setting.

Purpose of the Study:

  • To assess the feasibility and impact of the TREAT-ON virtual support model.
  • To evaluate changes in diabetes outcomes and patient acceptability.
  • To compare a virtual DSMES model with traditional in-person delivery.

Main Methods:

  • A 12-month nonrandomized trial involving patients with hemoglobin A1c (HbA1c) >9% in federally qualified health centers.
  • Intervention group (IG) received DSMES via videoconferencing through the TREAT-ON program.
  • Comparison with a propensity score-matched retrospective control group (CG) receiving in-person DSMES.

Main Results:

  • The IG showed significant HbA1c reductions, similar to the CG.
  • 64% of IG participants achieved self-management goals, with goal attainers showing further HbA1c decrease and reduced diabetes distress.
  • High acceptability of the TREAT-ON program was reported by all IG participants, irrespective of goal attainment.

Conclusions:

  • The TREAT-ON virtual support model is feasible, well-received, and as effective as traditional in-person DSMES.
  • Telehealth offers advantages for reaching and supporting high-risk patients in underserved rural areas.
  • Findings validate telehealth as a strategy to enhance diabetes self-management in resource-limited settings.