Improved Glucose Control for People with Diabetes Who Enrolled in a Multi-Chronic Condition Remote Monitoring Platform

DIABETES(2021)

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摘要
Background: Remote monitoring platforms (RMP) with personalized coaching continue to scale and have shown to be an effective tool for self-monitoring blood glucose (BG) and blood pressure (BP) for individuals with diabetes (DM) and hypertension (HTN). With HTN being a common risk factor for individuals with DM, it’s important to understand how RMPs can support individuals with both DM and HTN. Methods: Members were enrolled in a multi-chronic condition RMP with access to both DM and HTN programs. Using Propensity Score Matching to ensure no statistical differences in age, gender, race, DM type, insulin dependence, self-reported HbA1c, median zip code income, and zip code, two sample populations were constructed of those who were enrolled in DM only and DM+HTN between 1/1/2019 and 6/30/2019 and active on the platform for at least 1 year. For robust results, Bootstrapped Propensity Score Matching was used with 2,000 iterations. Paired t-test was used to compare reduction in estimated a1c at 6- and 9-months. Due to COVID-19, outcomes at 12-months were not evaluated. Results: No statistical differences between DM only (n=888) and DM+HTN (n=888) groups in age (56 vs. 56), gender (50% vs. 48% female), race (59% vs. 62% Caucasian), diabetes type (95% vs. 95% T2DM), insulin dependent (24% vs. 27%), started uncontrolled (49% vs. 50%), and self-reported HbA1c at time of registration (7.3% vs. 7.3%). Average estimated HbA1c reductions at 6 months were -0.46% for DM only and -0.65% for DM+HTN (p = 0.011). Reduction was similar at 9-month though no longer statistically different with values of -0.42% vs. -0.57%, respectively. Conclusions: Members enrolled in both DM+HTN versus DM only had improved glucose control within 6-months indicating RMPs that support multiple chronic conditions may have better outcomes. Future study is required to better understand the drivers of the clinical improvement for multiple conditions. Disclosure S. Liu: Employee; Self; Livongo, Teladoc Health. S. L. Painter: Employee; Self; Livongo. R. James: Employee; Self; Livongo, Teladoc Health, Stock/Shareholder; Self; Livongo, Teladoc Health. T. Kompala: Consultant; Self; Eli Lilly and Company, Employee; Self; Livongo. B. Shah: Employee; Self; Teladoc Health, Stock/Shareholder; Self; Teladoc Health.
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