Improving Diabetic Care Through Education and Innovation.

Area of Science:

• Endocrinology and Metabolic Diseases
• Digital Health and Telemedicine
• Nursing and Healthcare Quality Improvement

Background:

• Gaps exist in recognizing patients with type 2 diabetes mellitus (T2DM) eligible for continuous glucose monitoring (CGM) and leveraging telemedicine for self-management.
• Advanced practice registered nurses (APRNs) play a crucial role in diabetes care, yet their integration with novel technologies like CGM in telemedicine settings requires further investigation.

Purpose of the Study:

• To evaluate an APRN-led telemedicine program incorporating CGM for improving glycemic control and self-management in insulin-dependent T2DM patients.
• To assess the impact of CGM-derived time-in-range data on patient education and clinical outcomes within a primary care setting.

Main Methods:

• A 6-week quality improvement (QI) project implemented an APRN-led telemedicine program utilizing CGM.
• Patient-specific education was delivered based on CGM time-in-range data.
• Clinical metrics and the Diabetes Self-Management Questionnaire-Revised (DSMQ-R) were collected pre- and postintervention.

Main Results:

• The telemedicine program demonstrated a statistically significant improvement in CGM time-in-range outcomes (p < .001).
• APRN-led education led to significant reductions in body mass index (p = .002), systolic blood pressure (p = .010), and diastolic blood pressure (p = .007).
• Self-management skills significantly increased, as evidenced by DSMQ-R scores (p < .001).

Conclusions:

• An APRN-led telemedicine program integrating CGM data is effective in enhancing diabetes management for T2DM patients on insulin.
• This QI project underscores the value of technology-driven interventions in primary care for improving patient outcomes and self-care behaviors.