A Nurse-Led Telemonitoring Approach in Diabetes During the COVID-19 Pandemic: Prospective Cohort Study

Area of Science:

• Diabetes Management
• Telehealth
• Public Health

Background:

• The effectiveness of nurse-led telemonitoring approaches (NLTA) in diabetes management requires further validation.
• The COVID-19 pandemic highlighted the need for innovative healthcare delivery models.

Purpose of the Study:

• To assess the impact of a 12-month proactive NLTA on metabolic and psychological health in individuals with diabetes.
• To evaluate NLTA as a potential new model for diabetes care.

Main Methods:

• A 12-month prospective study involving a telemonitoring study group (TSG; n=91) and a comparison non-telemonitoring group (non-TSG; n=115).
• TSG participants received telehealth surveillance from a diabetes nurse educator at 3-month intervals.
• Key metrics included HbA1c%, weight, adherence to healthy behaviors, diabetes distress, anxiety, and depression.

Main Results:

• The TSG demonstrated a significantly greater reduction in HbA1c% compared to the non-TSG (4% vs 1%, P=.04).
• Adjusted analysis showed significant HbA1c% improvement in the TSG (P=.048) but not the non-TSG (P=.61).
• TSG participants were 40% less likely to experience an unfavorable rise in HbA1c% (OR 0.6).
• Elevated depression, anxiety, and diabetes distress were identified in women and younger adults (<30 years).

Conclusions:

• A proactive NLTA is a feasible diabetes care model with positive effects on glycemic control.
• NLTA can effectively identify individuals at psychological risk, enabling targeted interventions.
• Further investigation into NLTA models is recommended given increasing demands on diabetes care resources.