Outcomes of Continuous Remote Care in Pre-Diabetes and Type 2 Diabetes

ABSTRACT

Although telehealth existed and was widely implemented in the past, its potential and necessity was amplified in 2020 with the onset of the COVID pandemic. Many providers and patients shifted from periodic office visits to the use of episodic computer and telephone-based contacts. Although somewhat useful, these interactions cannot take the place of data and laboratory assessments, and always preclude direct patient examination. The true potential for telehealth requires data inputs from the patient to the provider, including anthropometrics and personal device data, with subsequent provider assessment, support, and follow-up therapeutic recommendations. Telehealth provides the opportunity to shift from an episodic encounter system (every 3-6 months) for chronic disease management to a continuous remote care paradigm in which data are continuously collected and reviewed, and patient support and education, together with therapeutic interventions may be instituted as rapidly and as often as needed. Diabetes serves as an ideal intervention to be managed by this continuous remote care telehealth model. This presentation will describe one model of diabetes care delivery using nutrition as the primary intervention through telehealth with data on sustainability, durability and patient outcomes, in a research setting over 5 years and in a real world setting over 2 years.