PITTSBURGH — How did a novel approach to provide diabetes specialty team care to rural veterans with Type 2 diabetes (T2DM) affect clinical outcomes and processes of care?
That was the question addressed in a new study from the University of Pittsburgh School of Medicine and three VAMCs in Pennsylvania — Pittsburgh, Erie and Butler. Results were published in The Science of Diabetes Self-Management and Care journal.1
For an initial six-week period, the Diabetes Care Network (DCN) provides veterans with T2DM and elevated hemoglobin A1c remote self-management education and support and medication management by a centrally located team of diabetes specialists. After that, participants are comanaged by remote liaisons embedded in rural primary care facilities for the remainder of the 12-month intervention.
For this pre-post intervention study, 87 veterans—mostly male and white— enrolled in DCN from two different clinical sites had baseline and 12-month post-enrollment A1c, systolic blood pressure, weight and LDL cholesterol levels collected and compared.
Results indicated that participants from both sites had significant improvement in A1c over the 12-month intervention period; that was compared to an increase in the 12 months prior to enrollment. Significant improvements in LDL and systolic blood pressure were documented at one site, with no significant change in weight at either site.
“DCN participants had significant improvement in A1c after not meeting similar goals previously in a robust primary care setting,” the authors concluded. “A technology-enabled collaborative partnership between centrally located diabetes care teams and local liaisons is a feasible approach to enhance access to diabetes specialty care for rural populations.”
- Zupa MF, Beattie J, Boudreaux-Kelly M, Larson M, et. al. Diabetes Care Network: A Novel Model to Disseminate Team-Based Diabetes Specialty Care in a Rural Population. Sci Diabetes Self Manag Care. 2022 Sep 20:26350106221125690. doi: 10.1177/26350106221125690. Epub ahead of print. PMID: 36125114.