The Results of Virtual Diabetic "Boot Camp"

Introduction: The use of telemedicine exponentially increased during the COVID-pandemic as it provided easier access as well as the provision of safety via social distancing. A 12-week intense telemedicine diabetic Bootcamp was therefore launched for patients with uncontrolled DM intended for high-quality outpatient diabetic care. Methods: Patients with DM seen at ambulatory clinics with HbA1c > 8.0%, were voluntarily enrolled from September 2020 to November 2021. The dietitians and diabetic educators conducted biweekly visits via telehealth. Patient demographics, HbA1c, BMI, BP were compared before and after the intervention. Results: A total of 134 patients were included for analysis and 94 patients (70.2%) completed the visits. Mean HbA1c change was -2.09% ± 2.4%, and HbA1c reduction was similarly observed across different age groups, gender, ethnicity, BMI, referred clinic types [Table 1]. A greater HbA1c reduction in patients who completed the visits was noted although it was not statistically significant. We found a negative correlation between the initial HbA1c and the change of HbA1c (coefficient -0.7709, p<0.0001, r2= 0.3899) . No significant BMI or MAP change was observed. Conclusions: This quality improvement project demonstrated an improvement in HbA1c for all poorly controlled diabetic patients, regardless of patient characteristics. Moreover, higher initial HbA1c was associated with a greater HbA1c reduction.

Is It All COVID-19? Resident Distress and Reasons for It in 2020.

OBJECTIVE: For resident wellness, it is important to understand and discern the relative contributions of each factor to resident stress. METHODS: After institutional review board approval, a 20-question survey instrument was provided to 90 residents across four specialties (Internal Medicine, Emergency Medicine, General Surgery, and Orthopedic Surgery) at a university-affiliated health system. The survey was completed from October through November 2020 by 63 residents for a 70% participation rate. Qualitative and quantitative analyses were used. RESULTS: The results showed a mean change in status in either direction of 2.66 points on an 11-point scale. Status changes were both positive (less stress) and negative (more stress). Related to the source of change in stress levels, 8 items were seen as predominantly influenced by residency training and 11 factors were predominantly influenced by the pandemic. One item was equally influenced by both. No item was primarily influenced by the sociopolitical climate. For 16 of the 20 items, changes in a negative direction were statistically greater than in a positive direction. CONCLUSIONS: Both positive and negative changes in resident stress status occurred during the pandemic period. Traditional residency stressors remained and because all of the factors were affected by both the pandemic and residency training, efforts to mitigate the negative effects of both need to continue.