Hood Korey K, Bergenstal Richard M, Cushman Terra, Gal Robin L, Raghinaru Dan, Kruger Davida, Johnson Mary L, McArthur Teresa, Bradshaw Amy, Olson Beth A, Oser Sean M, Oser Tamara K, Kollman Craig, Weinstock Ruth S, Beck Roy W, Aleppo Grazia
Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA.
International Diabetes Center, Minneapolis, Minnesota, USA.
Telemed J E Health. 2025 Jan;31(1):75-84. doi: 10.1089/tmj.2024.0093. Epub 2024 Aug 21.
The objective was to examine patient-reported outcomes (PROs) associated with access to a virtual clinic model for diabetes care. Adults with diabetes ( = 234) received virtual care, including support for continuous glucose monitoring (CGM) over a 6-month study period. Care was led by a Certified Diabetes Care and Education Specialist and focused on optimizing self-management skills and response to glucose values observed on CGM. After 6 months of CGM use and access to diabetes education, participants could opt in to another 6 months of follow-up with access to the virtual care team. Participants completed PRO surveys and had health and glycemic measures collected at baseline, 3, 6, and 12 months. Participants with type 1 diabetes ( = 160) were 44 ± 14 years and had mean baseline HbA1c of 61 mmol/mol (7.7%). Participants with type 2 diabetes ( = 74) were 52 ± 12 years and had mean baseline HbA1c of 66 mmol/mol (8.2%). Compared with baseline levels, at 6 months participants experienced less depression, diabetes distress, and hypoglycemic fears while also experiencing greater satisfaction with glucose monitoring, diabetes technology and specifically with CGM, and confidence for managing hypoglycemic ( < 0.05). For participants with type 1 diabetes, more time in the target range for glucose levels (70-180 mg/dL) was associated with less depression, diabetes distress, and hypoglycemic fears. PROs improved for adults with diabetes utilizing virtual diabetes care, including support for CGM use. Paired with the glycemic improvements observed in this virtual clinic study, there were robust benefits on the quality of life of adults with diabetes. ClinicalTrials.gov Identifier: NCT04765358.
目的是检查与使用虚拟诊所模式进行糖尿病护理相关的患者报告结局（PROs）。234名成年糖尿病患者在为期6个月的研究期间接受了虚拟护理，包括对持续葡萄糖监测（CGM）的支持。护理由一名认证糖尿病护理和教育专家主导，重点是优化自我管理技能以及对CGM上观察到的葡萄糖值的反应。在使用CGM并接受糖尿病教育6个月后，参与者可以选择再接受6个月的随访，并可接触虚拟护理团队。参与者完成了PRO调查，并在基线、3个月、6个月和12个月时收集了健康和血糖指标。1型糖尿病患者（n = 160）年龄为44±14岁，基线糖化血红蛋白（HbA1c）平均为61 mmol/mol（7.7%）。2型糖尿病患者（n = 74）年龄为52±12岁，基线HbA1c平均为66 mmol/mol（8.2%）。与基线水平相比，在6个月时，参与者的抑郁、糖尿病困扰和低血糖恐惧减少，同时对葡萄糖监测、糖尿病技术特别是CGM的满意度更高，以及对管理低血糖的信心增强（P < 0.05）。对于1型糖尿病患者，血糖水平处于目标范围（70 - 180 mg/dL）的时间越长，抑郁、糖尿病困扰和低血糖恐惧就越少。使用虚拟糖尿病护理（包括支持使用CGM）的成年糖尿病患者的PROs得到改善。与该虚拟诊所研究中观察到的血糖改善情况相结合，对成年糖尿病患者的生活质量有显著益处。ClinicalTrials.gov标识符：NCT04765358。
