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Diabetes

Telehealth for Diabetes Management

Getting started: Using telehealth technologies for diabetes care

A number of studies have demonstrated the safety and positive impact of telehealth technology for both type 1 and type 2 diabetes.

Telehealth technology for diabetes management includes virtual care, apps for smartphones, and digital tools for self-management. Technologies include smart devices, such as glucose meters, continuous glucose monitoring devices (CGMs), insulin pumps, and smartphones. Additionally, patients can use applications to self-monitor blood glucose levels, insulin dosage, diet, and physical activity.

When operating a telehealth practice for diabetes, it is essential to individualize recommendations for technology based on the patient's needs, desires, skills, and access to technology devices.

Use of telehealth in diabetes

Telehealth and telemedicine can also be used to deliver diabetes education, management, and monitoring services. This includes:

  • Diabetes self-management – Telehealth can support diabetes self-management activities such as blood sugar (glucose) monitoring and tracking. Using telehealth technology for diabetes management can improve patient engagement and interactions with the provider. Patients can enter data into apps on their smartphone and receive automated or tailored feedback from healthcare providers.
  • Diabetes education – Telehealth can be integrated into Diabetes Self-Management Education and Support (DSMES) programs. These programs provide information to patients with type 1 and type 2 diabetes on diet, lifestyle changes, blood sugar control, diabetes technologies, and self-administration of medications.
  • Specialty care consultations – Telehealth can help patients access specialty care such as endocrinologists, registered dieticians, or optometrists who can order and review laboratory tests, adjust medications, or develop personalized treatment plans.

The Centers for Disease Control and Prevention tracks statistics on the number of individuals living with diabetes in the United States.

Benefits of diabetes technology

Diabetes technologies have been shown to improve health outcomes. These technologies are continuously evolving to offer more precise treatment, increase access to timely information on glucose values, and improve patient safety, and offer discretion for patients who take insulin. There are also a number of other benefits:

  • Data visuals — Many technologies produce visualizations on web pages or smartphone applications that show a patient's key metrics, including current blood glucose, laboratory values, weight, medication adherence, physical activity, and lifestyle behaviors. These visualizations simplify the information to make it more meaningful and easier to interpret.
  • Technical support — Many of the technologies currently available have technical support from the vendor to instruct patients on how to upload data from their devices at home.

A majority of the telehealth technologies used to manage diabetes and other health conditions, including smartphone devices or remote monitoring tools, are asynchronous. Diabetes can also be managed through synchronous telehealth using virtual visits between a patient and provider to discuss the patient's health information and diabetes management strategies.

Ensuring patients can use diabetes technology

Telehealth technologies assist in the management of diabetes. Some individuals may need additional support when using technology, such as those who:

  • Have limited knowledge about the disease
  • Require additional support with medication use
  • Experience challenges self-monitoring their blood glucose
  • Do not have access to quality diabetes care
  • Worry about using technology for disease management

Before discussing telehealth technology with a patient, make sure they are comfortable using technology and are able to correctly use the technology to manage their diabetes.

Considerations for the use of telehealth technology for diabetes management

Telehealth technologies for diabetes allow patients to improve their self-care, learn about their condition, and communicate with their providers. There are several considerations when planning to use these technologies in your practice.

  • Cost — While private and public insurance plans cover most of the cost for digital devices for diabetes, patients may be required to pay a portion of these expenses themselves.
  • Patient comfort and preference — Patients may find it uncomfortable to wear a device and may not know how to handle the device or understand the information it provides.
  • Access and accessibility — Some patients, such as older adults, may be less comfortable using technology while individuals living in rural areas may not be able to find digital devices for diabetes management in their community. Patients can work with their provider to receive help and become more comfortable using the technology.
  • Actionable data — The use of the visualizations and quality indicators can help a patient understand their data and what they need to do to manage and improve their health.
  • Collaboration — Providers need to collaborate with patients and their caregivers so that they are able to upload data from their devices prior to a telehealth or in-person visit.
  • Privacy and security — Patients want to ensure that the data they share is safe and can only be accessed by their provider's office. It is important to take time to help patients understand that their data is protected by the same data security standards used to secure their electronic health record.

More resources

A Guide for Using Telehealth Technologies in Diabetes Self-Management — from the Centers for Disease Control and Prevention

How Can You Help Patients Use New Diabetes Technologies? — from the National Institute of Diabetes and Digestive and Kidney Diseases

Mobile Health Technology for Diabetes — from the Agency for Healthcare Research and Quality

Diabetes Technology: Standards of Care in Diabetes, 2023 — from the American Diabetes Association

Telehealth Technology for Diabetes Care

Telehealth Privacy Tips for Providers

Spotlight

PRISM

The Promoting Realistic Individual Self-Management Program (PRISM) provides diabetes care to patients in rural Montana. The PRISM program engages an interdisciplinary team that works directly with primary care providers in rural clinic settings to support the treatment of high-risk diabetes patients. The program incorporates telehealth technology that reaches rural clinics, increasing access to needed diabetes care services. It has generated significant improvements in diabetes-specific patient outcomes (blood pressure control, improved glucose levels), increases in patient awareness of how to self-manage their condition, and reductions in unnecessary healthcare utilization.

Learn more about Montana's rural diabetes program.