DIABETES DEVICE DATA IN VIRTUAL CLINIC VISITS: A NEW HEALTH DISPARTY?

ABSTRACT

Background and Aims: The burden of uploading diabetes device shifted from clinic staff to those living with T1D as a result of virtual encounters for COVID-19. Unfortunately, many patients were not familiar with the upload process, causing incomplete data availability. This study compared patients with device data available at the start of their routine virtual clinical visits vs. those that did not. Methods: Data was collected from individuals <23 years old, with T1D, who received virtual care at a network of tertiary pediatric diabetes clinics in the Midwest USA from 3/2020 to 11/ 2021. Successfully uploading any device data or having cloudconnected streaming data was defined as having engaged in data sharing. Results: Observations from 946 telehealth encounters were analyzed. Only 52.9% (n = 383) had device data uploaded before their visit. Mean HbA1c (9.5% vs 8.5%, p-value <0.001), and mean time in range (44.7% vs 35.7%, p-value <0.001) were lower in those that had uploaded/streamed their data before their clinic encounter. Those with a longer duration of diabetes, selfidentifying as Black or African American, and those with public insurance were less likely to have data available at the start of their visit. Conclusions: Data from diabetes devices are integral to routine, effective, and safe management of insulin therapy. Statistically significant differences in access to device data were noted in those with public insurance and those who self-identify as African American. HbA1c and TIR were also lower. This study highlights the importance of equitable access to diabetes devices and continued advancement in auto-data streaming technologies.