By Heather Nelson

Rapid advances in telehealth have provided doctors a level of convenience (1) that lends itself to well-rounded patient care. In this article, we will highlight some benefits of telemedicine relating to diabetes management.

Rise of Diabetes Distance Care

Telemedicine is the use of technology in delivering medical care to patients from a distance (2). Once considered necessary for rural or underserved communities, telemedicine has transformed over the past 50 years into a vibrant, integrated service utilized by hospitals and physicians around the globe (3).

Diabetes telemedicine has combined the wonders of technology and the necessity of recurring specialty care to enable providers to be more proactive. One effect of telemedicine on the management of diabetes is that providers are able to help their patients see improved HbA1c levels (4).

As always, in the grand scheme of diabetes therapy solutions, the measuring stick has always been the almighty HbA1c. As technology improves, doctors are seeing the added benefits of reading telehealth data from sensors to measure Time-In-Range as well (TIR) (5).With both of these in mind, a new treatment option can succeed or fail based on the ability to improve HbA1c ranges consistently or provide greater time in optimal blood glucose range. This seems to be no struggle for telemedicine.

The benefits of telemedicine in diabetes distance care are so promising that the CDC (Centers for Disease Control and Prevention) ran a 2-year study in rural Alabama and Georgia (6). The outcome showed decreased hemoglobin A1c as well as average reduced travel time of over 78 minutes per visit. Based on their findings, the CDC declared that “diabetes care delivered via telemedicine was safe and was associated with time savings, cost savings, high appointment adherence rates, and high patient satisfaction.”

Additionally, another study found lower HbA1c levels as well as improved blood pressure and cholesterol levels after just one year of telemedicine (7).

These studies might seem great on paper, but you might be asking yourself…

“How can telemedicine help me manage my diabetes?”

Well, I’m so glad you asked. Welcome to “Telediabetes”!

We all know that diabetes is a chronic disease that requires regular and constant monitoring. Some providers wish to see their patients bi-annually, while others request quarterly or even monthly check-ups. The practical challenges of regular office visits can sometimes prove challenging, and in the gap of in-office care and at-home management, the person with diabetes flounders. This gap is precisely where telemedicine shines.

4 Reasons Why Real-time Feedback No Longer Requires Face-Time Appointments

• Is the driving distance to your endocrinologist office making those quarterly visits hard to squeeze into your lunch hour? Transmit your health records and let telemedicine connect you for guidance in basal rates adjustments or dosing tweaks with less time off work.
• Is prohibitive weather keeping you from talking with your mental health practitioner about diabetes challenges? Log into a portal and send a message detailing your snow-day concerns straight away. They can respond via email or video conference to provide real-time support and encouragement.
• Are school absences piling-up making it hard for your child to miss another half-day for their monthly appointment? Simply log-in, upload the latest chart data you’ve been keeping, and let their doctor analyze the trends and suggest small changes. These tweaks can make a big impact in keeping them at optimal health while keeping them in school and learning (8).
• Have travel challenges made your food dosing questionable? Send a message to your certified diabetic educator (CDE) and let them guide you to healthier solutions and safer swagging.

Whatever reason you have to miss out on those essential office visits, telemedicine doesn’t judge. Telemedicine understands.

With Great Tech, Comes Great Responsibility

The rapid advances of tracking devices and sensors mean we can readily gather reliable glucose data in a fairly simple manner. But that’s not the full picture your healthcare team will need. We all know that taming the diabetes monster requires a multi-faceted approach. The rise of newer and better diabetes management technology has perfectly poised the diabetic community to benefit from telemedicine and all it has to offer including lifestyle modifications, mental health checks, and more. But we must have solid data to reap those benefits.

The best way to take advantage of all the rewards of telemedicine is to provide good and useful data. The more data you can afford, in a succinct and readable format, the better distance care your provider can give. Utilizing technology means you should be able to provide food records, insulin doses, basal and bolus rates (for our pump-loving friends) as well as activity, health events, and other biometrics like Ketones, HbA1c readings, weight and body measurements.

Beyond the tracking of data itself, presentation also matters. Clearly you can’t courier-pigeon over a stack of origami-worthy paper logs and in this day and age, you shouldn’t have to. Organize your logs into a format that is easily accessible for your healthcare provider. If they need CSV, Excel sheets, or PDFs, provide what they can read.

How mySugr PDF Reports Makes Data Sharing Easy

If you are reading this and genuinely shocked to learn that you need to log things like insulin dosing and food intake, allow us to usher you out from under your rock and into the age of technology by introducing the reporting feature in the mySugr app! Indeed we believe you are the captain of your pancreas. As such, the ability to harness all your well-tracked data into usable information for you and your doctor is a key focus of our app. Using the reports feature you can quickly:

• View your own data at a glance, anytime, to see trends.
• Select your own time period to see only the data you wish to discuss. No more information overload or sifting through months of records needlessly.
• Send preferred data to your doctor via email for quick communication about necessary formula changes. Even select from one of our three output formats for optimal communication.
• Stay in constant communication and more!

Using the data in these reports, you can truly be the master of your own fate. The reports are meant to empower you as you discuss your treatment decisions with your provider, making the conversation more constructive and putting you back in the driver’s seat of your care.

And for our US friends in the diabetic online community (DOC), we still have our fabulous bundle! mySugr has over 2 million registered users to-date and a 4.6+ rating on the App Store and Google Play. The mySugr Coaching service is second-to-none and utilizing our monthly subscription gets you:

• Blood glucose meter
• Lancing device (with a box of refills…so that’ll last you basically forever, amiright)
• Unlimited test strips (new shipments arrive before you even run out!)
• The mySugr Pro App (that includes the ability to estimate the HbA1c!)
• Diabetes coaching (with a pretty top-notch team)
• Free shipping

And all the tech-support a person could need!

Indeed, we believe telemedicine is here to stay (9) and with good reason!

People living with diabetes can find more freedom and a better quality of life with the rising accessibility of a healthcare team armed and ready to interpret and predetermine the many responses to all the data we track.

As always, mySugr stands on the edge of change ready to help usher in this new age with open arms and glucometers for all Rise up mighty warriors and embrace the freedom of “telediabetes”!

(1) Wicklund E. Leveraging Primary Care Telehealth for Convenience and Quality. https://mhealthintelligence.com/features/leveraging-primary-care-telehealth-for-convenience-and-quality(2) White LA, Krousel-Wood MA, Mather F. Technology meets healthcare: distance learning and telehealth. Jan. 2001. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3116779/

(3) eVisit: The Ultimate Telemedicine Guide | What Is Telemedicine? 2018. https://evisit.com/resources/what-is-telemedicine/

(4) Hompesch M, Kalcher K, Debong F, Morrow L. Significant improvement of blood sugar control in a high risk population of type 1 diabetes using a mobile health app – A retrospective observational study. Poster presentation at ATTD 2017, Paris, France.

(5) Beck R, Bergenstal R, Riddlesworth T, Kollman C, Li Z, Brown A, Close K. Validation of Time in Range as an Outcome Measure for Diabetes Clinical Trials. March 2019.

(6) Xu T, Pujara S, Sutton S, Rhee M. Telemedicine in the Management of Type 1 Diabetes. 2018. http://dx.doi.org/10.5888/pcd15.170168

(7) Steven Shea, MD, Ruth S. Weinstock, MD, PhD, Justin Starren, MD, PhD, Jeanne Teresi, EdD, PhD, Walter Palmas, MD, Lesley Field, RN, MSN, Philip Morin, MS, Robin Goland, MD, Roberto E. Izquierdo, MD, L. Thomas Wolff, MD, Mohammed Ashraf, BA, Charlyn Hilliman, MPA, Stephanie Silver, MPH, Suzanne Meyer, RN, Douglas Holmes, PhD, Eva Petkova, PhD, Linnea Capps, MD, Rafael A. Lantigua, MD, PhD, for the IDEATel Consortium. A Randomized Trial Comparing Telemedicine Case Management with Usual Care in Older, Ethnically Diverse, Medically Underserved Patients with Diabetes Mellitus. Jan-Feb. 2006. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1380195/

(8) Please note that all mySugr products have a minimum age limit of 16 years for the mySugr Logbook and 18 years for the mySugr Bolus Calculator (for more details please read mySugr’s General Terms & Conditions).

(9) Klonoff David C., M.D. Using Telemedicine to Improve Outcomes in Diabetes—An Emerging Technology. July 2009. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769943/

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