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The Centers for Disease Control and Prevention estimates that 37.3 million people in the United States — 11.3% of the population — live with diabetes.
While the incidence of new diabetes cases has trended slightly downward over the past decade, the total percentage of the population with diabetes has increased over that same period as Americans have aged and become more obese. This continued prevalence, paired with strained resources in the endocrinology field, demands that we seek ways to maximize our ability to responsibly manage every patient with diabetes.
Virtual Care: Enhancing Our Approach to Diabetes Management
Effective diabetes management requires a team approach.
When a patient with diabetes is at home, they are vulnerable. They do not have a clinician with them to monitor and interpret their A1C levels, evaluate the numerous factors that impact blood sugar levels, and coach them on the healthy behaviors that promote the best outcomes.
Virtual care, however, addresses all these concerns associated with a lack of continuity of care. It also addresses the concern about limited medical resources, with one study showing that virtual care can help drive a twofold increase in the number of patients that a clinician can safely and effectively manage.
Knowing Your Numbers
Knowing your numbers is a core element of effective diabetes management.
A standard virtual care program for diabetes management will include a glucometer and a blood pressure monitor combined with automated assessments delivered either via an app or interactive voice response (an automated phone system for delivering pre-recorded information). Other devices, such as a weight scale or pulse oximeter, may be added if comorbidities such as pulmonary disease or obesity are present.
Collectively, daily measurements combined with self-reported information on the patient’s symptomology, behavior, access to care, and condition literacy provide a fuller, more accurate, and timelier picture of a patient’s health than what is gleaned from infrequent visits to a provider’s office. This continuous monitoring not only helps clinicians help patients better manage (and improve) their condition but also alerts clinicians to intervene at the earliest signs of trouble, thereby addressing issues before they become emergencies.
Medication Adherence
It is also important that patients consistently take their prescribed medications, regardless of how they feel. Virtual care promotes such adherence through a two-stage method. First, patients self-report their medication adherence through electronic surveys. This self-reporting is then reconciled regularly through a medication review conducted by a clinician over the phone.
Healthy Lifestyle
While taking medication regularly is critical for improved glycemic control, healthy lifestyle habits are also important means of managing blood sugar levels — and may even reduce a patient’s need to take medication.
Virtual care uses a multipronged approach to promoting healthy lifestyle factors that improve diabetes management. During the initial patient assessment, the clinician identifies risk factors associated with poor glycemic control, including obesity, a high-carbohydrate diet, alcohol use, smoking, and medication adherence. If diet is an issue, the care manager will provide education on a prescribed diet. If weight is an issue, both diet and exercise will be discussed. Dependent on the care manager’s risk assessment, the patient may be referred to a diabetes educator for further intervention.
This promotion of healthy habits through clinician-patient interactions and self-reporting is further enhanced through education. An automated, interactive, individualized education regimen includes access to information about diet, medication, exercise, and other self-care practices that are important for glycemic control and to tutorials that educate patients about warning signs of diabetes-related complications.
Effective Diabetes Management for Everyone
The virtual care model is founded upon the ideal that everyone should be provided with high-quality healthcare.
A wide variety of factors, including a patient’s access to medical appointments, transportation, clean water, and safe housing, can have a profound impact on an individual’s health outcomes. That is why social determinants of health are thoroughly and continuously assessed for every patient participating in a virtual care program. If any potential social barriers to care are identified, the care team works to remove those unnecessary obstacles.
The Results
Virtual care works.
A study of an AMC Health virtual care program in the New York City area found that 81% of the 800 study participants had significant and sustained improvement in glycemic control, with HbA1C reduced by an average of 1.8 points for the entire study population. The nearly two-thirds of study participants who also had hypertension at the outset of the study reduced their diastolic blood pressure by an average of 5 mmHg, representing a 21% reduced risk of stroke.
AMC Health’s virtual care solution consistently delivers similar positive health outcomes for its other customers, not to mention consistently significant returns on investment.
With these positive outcomes in mind, here is the final diabetes management tip — if you do not already have a virtual care partner, start searching for one today.
