Medicine has transformed radically since March 2020, in light of the covid-19 pandemic. The field of diabetes medicine, especially, was primed to help patients succeed as more telemedicine clinic visits became available. The reasons for this are listed in the following paragraphs.
Diabetes medicine providers have been using glucose data sharing technology for several years now. Glucose meter apps, including but not limited to OneTouch Reveal, Contour Diabetes, and ReliOn Life, allow patients to track and share glucose data with their provider. Patients who use continuous glucose monitors (CGMs) can share data using LibreView (for the FreeStyle Libre CGM) and Clarity (for the Dexcom CGM). Not only can patients review this data during a clinic visit with their providers but they can also send or remind their providers to review this data between visits. Additional apps that patients can use to share data with their providers include the following: Glucose Buddy and mySugr.
For those patients with type 1 or type 2 diabetes who receive insulin via a pump, Medtronic, Tandem, and Omnipod all have portals by which patients can upload data and share pump use information with their providers. This, with or without data from a CGM, can prove invaluable when providers are working with patients to adjust pump settings if needed to improve glycemic control.
Moreover, other important data to help manage diabetes and diabetes-related comorbidities, including blood pressure and weight, can be measured by patients at home and relayed to providers; this information is invaluable in helping make lifestyle and medication recommendations.
Finally, patients with diabetes are greater risk for complications from covid-19, so it is of particular importance that these patients be given the opportunity, if appropriate, to meet with their providers via telemedicine.
The importance of the “village” of allied health that is needed to care for the patient with diabetes is being recognized by insurers, as the Centers for Medicare and Medicaid Services is reimbursing Diabetes Self-Management Training programs, including those led by PharmDs and RNs (1).
The other benefits to patients of telemedicine can be generalized to all patients, not patients with diabetes alone. These include the time spent traveling to clinic and the costs of being absent from work for part of the day to attend an in-person clinic visit (2).
In summary, the care of patients with diabetes has been able to adapt to the field of telemedicine admirably, in part because the foundation, i.e., diabetes technology, was available and being used by patients and providers to improve the health of these patients.
By Sudipa Sarkar, MD MSCI
References
- CMS Removes Restrictions Around RNs and Pharmacists Furnishing DSMT via Telehealth.
https://www.diabeteseducator.org/news/perspectives/aade-blog-details/adces-perspectives-on-diabetes-care/2020/08/12/cms-removes-restrictions-around-rns-and-pharmacists-furnishing-dsmt-via-telehealth. Accessed August 14, 2020.
- Malasanos T and Ramnitz MS. “Diabetes Clinic at a Distance: Telemedicine Bridges the Gap.” Diabetes Spectrum 2013 Nov; 26(4): 226-231.
*References to specific products in this article does not represent endorsements of those products.
