Worldwide, diabetes affects over 463 million adults, with 79% living in low- to middle-income countries. In the U.S. alone, over 34 million people of all ages are afflicted, and the prevalence is 17% higher in rural areas than in urban areas. Telehealth could be the answer to reaching many of these patients who otherwise do not receive proper care in the management of their diabetes.
Over the last decade, ischemic heart disease, stroke, chronic obstructive lung disease, and lower respiratory infections have remained the leading causes of death worldwide. Uncontrolled diabetes can lead to all these killers and many other complications. It is imperative to get diabetes under control, but many patients have lacked access to the proper care needed for various reasons. The recent COVID-19 pandemic has skyrocketed the use of telehealth services, making this a crucial time for specialized diabetes management teams to jump on board. Telehealth has the ability to increase access to care and improve the quality of care for patients with diabetes.
A randomized controlled trial published in Diabetes Technology & Therapeutics showed improved quality of care and positive outcomes in low-income patients with type 2 diabetes living in rural communities who received telehealth services. The researchers used A1C results, or the average plasma glucose concentration, as the primary measurement. The higher the A1C, the more uncontrolled diabetes. The more uncontrolled diabetes, the more complications that can develop. Trial results showed a faster decline in A1C levels of the telehealth group compared to the usual care group, significantly lower A1C levels in the telehealth group, and improved communication between patients and providers in the telehealth group.
Much of the success of the trial was attributed to patient adherence to prescribed therapy and lifestyle modifications. Improved patient adherence was due to the ease of reporting daily blood glucose values, the ability of nurses to quickly respond to a patient’s status and titrate medications if needed, and regular communications between the patient and nurse case manager. The findings from this study are consistent with mounting evidence that telemedicine can be highly beneficial for managing diabetes.
Similarly, the introduction of virtual health can also assist patients with blood glucose management after discharge. Every year, hospitals are penalized by CMS for having too many hospital readmissions. In fiscal 2020, CMS will penalize approximately $563 million in payments to hospitals. Of those evaluated, 83% of these hospitals will receive a penalty. This is an astounding amount, but it does not need to be this way.
The readmissions evaluated included pneumonia, chronic obstructive pulmonary disease, acute myocardial infarction, coronary artery bypass graft surgery, and knee or hip replacements. Each of these ailments or surgeries is affected by glucose control: glycemic abnormalities lead to complications, leading to readmission rates. The extra support and assistance with blood glucose management available through virtual health is vital in reducing the number of readmitted patients.
When patients come home from the hospital, they can feel overwhelmed dealing with their recovery and many discharge instructions. Often, their glucose management falls by the wayside considering their more acute issues. Keeping blood glucose within goal range becomes extremely important during recovery, as uncontrolled blood glucose increases the risks of poor healing, infection, and many other complications that can lead to hospital readmission.
A glycemic management team should initiate virtual hospital follow-up visits one to two days after discharge. These follow-up visits will guide patients in the self-care of diabetes and highlight the importance of glycemic management in their recovery process. Furthermore, proper self-care of diabetes will decrease the risk of developing additional complications such as stroke or myocardial infarction. Much as telehealth allows specialists to reach patients with diabetes in rural locations, virtual follow-ups are particularly vital outside of urban areas where patients may have difficulty getting to their provider’s office. Proper glycemic management allows for better healing, faster
recovery, and reduced complications – all of which reduce the chances of being readmitted to the hospital.
Telehealth has great potential to improve access to and quality of care for patients living with diabetes. As the landscape and demand for virtual medicine shift, glycemic management teams have the opportunity to embrace telehealth technologies to facilitate an increase in proper diabetes management. Those that do will see a reduction in resultant complications, both in-hospital and post-discharge, resulting in
lower readmission rates and more positive patient outcomes.
Learn more about partnering with GlyCare for a turn-key diabetes management service. For more information on how to incorporate either in-person or virtual diabetes management, contact us today.