Real-World Clinical Outcomes of a Virtual Integrated Diabetes Program for People with Type 1 and Type 2 Diabetes

Objective: To examine the clinical efficacy of a virtual diabetes care model integrating remote continuous glucose monitoring and multi-disciplinary care. Research Design and Methods: We performed a retrospective chart review of patients with type 1 and type 2 diabetes in Carbon Health’s diabetes program with a baseline A1C on file. Primary outcome measures include change in A1C and long-term time in range (%LTIR), long-term time below range (%LTBR), and glucose management indicator (GMI), calculated from aggregated continuous glucose monitoring data since the first week time in range >70% was achieved. Exploratory measures included change in weight and change in Problem Areas in Diabetes (PAID) survey scores. Patients were asked to complete a questionnaire assessing their satisfaction. Results: A total of 230 patients (36.1% with type 1 diabetes; 45.6% taking insulin; median baseline A1C 8.0%) were included. Over a median follow-up of 38 weeks, patients across all baseline A1C categories saw A1C reductions, up to −4.3% in patients with baseline A1C ≥9.0%. Patients with baseline A1C ≥ 7.0% maintained a median (IQR) GMI 6.8% (6.4%–7.3%), %LTIR 82.3% (66.3%–94.9%), and %LTBR 0.4% (0.1%–1.3%) on long-term data. Improvements in PAID score and weight in patients with overweight/obesity were observed. Of 51 survey respondents, all expressed satisfaction with the program. Conclusions: These findings suggest that a virtual integrated diabetes program can help people with type 1 and type 2 diabetes achieve and maintain clinical glycemic targets. Benefits were accompanied by improvements in diabetes self-management, diabetes-related distress, and weight in overweight individuals.