Clinical Outcomes of Multidisciplinary Remote Patient Monitoring for Patients With Poorly Controlled Type 2 Diabetes: Retrospective Cohort Study

Abstract Background Multidisciplinary remote patient monitoring (RPM) programs may support diabetes management by enabling ongoing glucose monitoring and timely treatment adjustments between clinical encounters. Evidence describing real-world implementation of RPM programs for diabetes in high-risk populations remains limited. Objective This study evaluated clinical outcomes of a multidisciplinary RPM program for patients with uncontrolled type 2 diabetes mellitus (T2DM). Methods Adults with T2DM, hemoglobin A 1c (HbA 1c ) >7%, and insulin therapy who enrolled in an RPM program at the University of Mississippi Medical Center between July 2020 and December 2022 were included. Patients received a Bluetooth-enabled glucometer and structured follow-up from nurses and pharmacists operating under a collaborative practice agreement. A propensity score–matched control group receiving usual outpatient care was identified. The primary outcome was the change in HbA 1c from baseline to follow-up. Secondary outcomes included acute care use and RPM engagement, including program completion. Results Among 109 RPM participants, mean HbA 1c decreased from 10.79% (SD 2.35%) to 8.85% (−1.94 percentage points). In the matched cohort of 95 RPM and 95 control patients, HbA 1c decreased by 1.97 versus 1.71 percentage points, respectively (between-group difference: −0.27, 95% CI −1.01 to 0.47; P =.48). Among matched RPM participants, program completers (n=19) had greater HbA 1c reductions than noncompleters (n=76; −3.41 vs −1.61 percentage points; P =.01). Acute care use occurred in 13.7% of RPM participants versus 24.2% of matched controls; rates were 23.4 versus 24.2 per 100 person-years, respectively. Conclusions Substantial improvements in glycemic control were observed among patients with uncontrolled T2DM enrolled in a multidisciplinary RPM program. Greater HbA 1c reductions were observed among program completers, although this exploratory finding may reflect response-related selection because program completion required achievement of the program’s glycemic target. Further study is needed to determine the comparative effectiveness of RPM and strategies to sustain patient engagement.