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Diabetes

Telehealth for Diabetes Management

Engaging patients in telehealth for diabetes care

Health care providers and professionals should make sure that telehealth is appropriate for each patient and that patients are comfortable with the technology.

Studies have demonstrated that using telemedicine for diabetes care can help reduce the patient's Hemoglobin A1c (HbA1c), cholesterol, and blood pressure levels. It is important to follow a standardized process to educate patients on how to use diabetes technologies and telehealth. This includes providing information on how patients can use these technologies to manage their care and better communicate with their providers.

Educate and engage patients, family members, and caregivers

  • Select the right technology — It is important to ensure the patient has the right technology for their needs. They also need to know how to use it correctly.
  • Include family members and caregivers — Discuss and seek consent from the patient. This should include the patient's family members and/or caretakers, when appropriate. They can support the patient.
  • Educate the patient — There is no “one-size-fits-all” approach to educating patients. It is important to make sure the patient understands the technologies they will use to manage their diabetes.
  • Review the technology — During video visits, it is important to explain how to use the recommended technology. Patients should be encouraged to ask questions.
  • Respect differences — The information communicated to the patient should be culturally competent, support health equity, and adhere to the culturally and linguistically appropriate services (CLAS) standards.

Use patient-reported data to tailor care

  • Upload data before the visit — Create a process that allows patients to upload data from their device prior to a telehealth visit. It is important to let the patient know when and how to upload this information. The results of laboratory work, including HbA1C, glucose, and appropriate blood/urine tests, should be sent to the provider before the appointment.
  • Review the data — Take time to review the patient's data with them and explain how to interpret the data. Use this time to help the patient problem solve. It is also important to provide emotional support and encouragement. Patients need to understand how to follow their care plan and how to manage their health. This includes understanding the types and amounts of medications prescribed, how to regularly track their blood glucose levels and symptoms, and when to follow up with their health care provider.

Developing a telehealth process for gestational diabetes

Gestational diabetes is a type of diabetes that occurs during pregnancy. Doctors most often test for gestational diabetes between 24 and 28 weeks of pregnancy. Providers can use telehealth to provide support and self-management guidance to women with this condition. It is important to establish a process that focuses on lifestyle changes. Providers can also encourage the use of certain technologies to monitor glucose (such as continuous glucose monitors used with smartphones to track blood sugar levels) or to deliver insulin, if needed. Remote patient monitoring for managing diabetes in pregnancy has been associated with better glycemic control.

Troubleshooting challenges

  • Video visits — Technical challenges with technology may cause patients to be late or miss a telehealth appointment. Patients that experience technology challenges are less likely to use telehealth in the future. Clinicians should provide support to help patients join a telehealth session.
  • Asynchronous telehealth — Depending on the type of technology, the patient may need help downloading an application or learning how to use a technology device. This includes how to upload data and what steps to take if they experience problems sending the data. It is important to ensure that the patient has a connection to the internet to upload their data and sufficient bandwidth to support a two-way video telehealth visit.

More resources

Diabetes Self-Management Education and Support (DSMES) Toolkit — from the Centers for Disease Control and Prevention

How can you use telehealth to provide patient-centered diabetes care? — from the National Institute of Diabetes and Digestive and Kidney Disease

Best Practice Guide for Telehealth for Chronic Conditions.

Spotlight

The Virginia Center for Diabetes Prevention and Education (VCDPE) at the University of Virginia offers free diabetes prevention and management tele-education. These programs are available in community health centers, small rural hospitals, health districts, and Critical Access Hospitals within the state. These sites use teleconferencing to disseminate diabetes prevention and self-management information. The education sessions and materials are free. Some of these services include:

  • Basics of Diabetes
  • Nutrition Basics
  • Diabetes Self-Management Skills
  • Healthy Eating Lifestyle Changes

VCDPE also has a diabetes education program. They provide patients with tablets that are preloaded with educational information about diabetes self-management. Patients participate in group meetings led by a certified diabetes educator. This is available to healthcare facilities to share with people with diabetes who have limited internet access.

Find out more about the Tele-Education Program for Diabetes at the University of Virginia