Glycemic outcomes and patient satisfaction and self-management improves in transition from standard to virtual multidisciplinary care

Aims: With advances in cloud-based technologies, there has been a rise in remote T1D care. We hypothesized that transitioning T1DM care to a virtual, multidisciplinary clinic could improve measures beyond HbA1c. Methods: To assess the impact of transitioning from standard to virtual T1DM care, we evaluated glycemic measures and patient reported outcomes. Results: Sixty-one adults with T1DM were included, with mean age 40.2 +/- 13.5 years and diabetes duration 16.9 +/- 9.0 years. Most patients were treated with insulin pumps and CGM. The number of annual diabetes care encounters rose from 2.1 +/- 4.2 to 12.8 +/- 5.5. Baseline HbA1c was 7.9 +/- 1.6 %(63 +/- 16.9 mmol/mol), declining to 7.3 +/- 1.1 %(56 +/- 8.5 mmol/mol) and 7.1 +/- 1.0 %(54 +/- 7.7 mmol/mol) at 6 and 12 months respectively (p < 0.001 for both). In parallel, TIR improved from 63.1 +/- 19.3 % to 69.2 +/- 13.8 % (p < 0.001) and 67.5 +/- 19.4 % (p = 0.03) at 6 and 12 months respectively, while TBR declined. Scores from validated diabetes treatment and self-management questionnaires rose significantly and these rises were associated with a reduction in HbA1c, the latter score was also associated with increased TIR. There was a trend toward a correlation between encounter frequency and improvement in HbA1c and TIR. Conclusions: Transitioning from standard to virtual, coordinated, multidisciplinary T1DM care is associated with increased visit frequency, improving glycemic control, treatment satisfaction and self-care behaviors.