7393 Measuring Diabetes Outcomes of Telemedicine Versus In-Office Visits at an Endocrinology Practice in Rural West Virginia

Abstract Disclosure: C. Muojieje: None. H.K. Driscoll: None. Background: West Virginia has limited specialty access despite high diabetes rates. Telemedicine expanded during COVID-19 as an alternative for care delivery while encouraging social distancing. Objective: Compare diabetes outcomes between telemedicine and in-office visits at the Marshall Health Endocrinology practice in Huntington, West Virginia Methods: Retrospective cohort study using records from Marshall Health Endocrinology from March 2019-March 2023. Adults aged 18-65 with type 1/type 2 diabetes with baseline HbA1c >7% on medications were included with clinic follow-up every 6 months. Primary outcome was HbA1c change. Secondary outcomes were changes in LDL cholesterol, triglycerides, microalbumin/creatinine ratio and diabetes hospitalizations. Change scores were calculated by subtracting values from the visit from values at 3-6 month follow up. Wilcoxon Signed Rank test compared outcomes within each patient. The study was approved by the Marshall IRB. Results: Of 72 patients, 8 had complete data allowing comparison between visit types for HbA1c. HbA1c increased after telemedicine (mean=-1.2; SD=2.08) but stayed the same after in-office (mean=0.03; SD= 0.19; p=0.039). Insufficient data precluded analysis of secondary outcomes. Conclusion: Results suggest potentially worse glycemic control with telemedicine versus in-office visits, unlike prior studies finding equivalence between telemedicine and in-office care for diabetes outcomes. This study’s findings were similar to previous study that have found telemedicine had slightly worse outcomes. This contrasts with other previous studies that generally found telemedicine to be equally efficacious for diabetes management. The small sample size precludes definitively establishing worse outcomes for telemedicine. Larger randomized studies are needed to definitively compare outcomes between visit types for rural diabetes populations and determine if telemedicine truly delivers subpar diabetes outcomes compared to in-office care. Presentation: 6/3/2024