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The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
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Improving glycemic control in diabetes through virtual interdisciplinary rounds.

Abby F Hoffman, Cindy Leslie Roberson, Pamela Cohen

  • 1Duke Population Health Management Office, 3100 Tower Blvd, Ste 1100, Durham, NC 27707.

The American Journal of Managed Care
|March 8, 2024
PubMed
Summary

Virtual interdisciplinary diabetes rounds improved glycemic control, reducing hemoglobin A1c (HbA1c). This innovative model offers efficient, low-cost access to specialists for primary care providers managing diabetes.

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Area of Science:

  • Endocrinology
  • Health Services Research
  • Diabetes Management

Background:

  • Team-based diabetes management improves outcomes but faces cost and complexity challenges.
  • Innovative care models are essential for enhancing diabetes outcomes.
  • Virtual interdisciplinary diabetes rounds offer a potential solution.

Purpose of the Study:

  • To evaluate the efficacy of virtual interdisciplinary diabetes rounds in improving glycemic control.
  • To assess the impact of virtual rounds on hemoglobin A1c (HbA1c) levels.

Main Methods:

  • Retrospective cohort study (July 2018-December 2021).
  • Difference-in-differences analysis comparing patients whose providers received virtual rounds advice versus those who did not.
  • Inclusion criteria: diabetes, HbA1c 8-9%, or provider referral.

Main Results:

  • Overall, virtual rounds were associated with a 0.3-point reduction in HbA1c (95% CI, 0.1-0.4).
  • Provider adoption of recommendations correlated with a 0.5-point HbA1c reduction at 6 months post-rounds (95% CI, 0.1-0.9).
  • No significant difference in HbA1c was observed at one year post-rounds.

Conclusions:

  • Virtual interdisciplinary rounds are effective for proactive diabetes management recommendations.
  • This approach provides efficient, low-cost, and timely specialist support to primary care.
  • Virtual rounds represent a valuable tool for improving diabetes care delivery.