Evaluating Availability of Glucose Data During In-person versus Telemedicine Visits in an Endocrinology Specialty Clinic

ABSTRACT

Introduction: Blood glucose (BG) data are essential for diabetes management. Before Coronavirus Disease 2019 (COVID-19) pandemic, BG data would be obtained as patient fingerstick BG logs, or insulin pump and/or continuous glucose monitor (CGM) data downloaded from patients' devices during in-person visits. Transition to telemedicine during the pandemic altered clinic workflow and challenged access to BG data. This study compares availability and sources of BG data in telemedicine versus in-person endocrinology visits. Research Question or Hypothesis: Hypotheses 1) BG data availability was higher for in-person versus telemedicine visits. 2) More fingerstick BG logs were available for in-person visits. 3) Availability of pump and/or CGM data was higher during in-person versus in-person visits. Study Design: This was an observational retrospective study conducted via chart review. Methods: We randomly screened adult diabetes management clinic visits at Banner 'University Medicine Endocrinology Clinic from 6/1/2019 to 12/13/2019 (in-person, Group A) and 6/1/2020 to 12/31/2020 (telemedicine, Group B). Incomplete visits were excluded. Chi-square test was used for between group comparison. Results: Out of the 766 screened visits, 200 were included in Group A and 199 in Group B. Overall, availability of BG data (from all noted sources) was higher for Group A (79%) than Group B (46.2%), P<0.001. More fingerstick BG logs were available for Group A (78.5%) than Group B (21.5%), P<0.001. Availability of insulin pump and/or CGM data was not statistically significant between the two groups (54.1% vs 45.9%, P=0.210). Conclusion: The higher overall BG data availability for in-person visits was driven by that of fingerstick BG logs. Pump and CGM data availability did not differ between groups suggesting that those data were successfully shared with the clinic for telemedicine visits. Enhancing ability to share fingerstick BG data for telemedicine visits should be considered. Future studies are needed to assess availability of clinically relevant data.