A digital health-based pilot program by UnitedHealth Group and Children’s Hospitals and Clinics of Minnesota showed meaningful improvements in blood glucose control and quality of life measurements, according to new research.
The study specifically showed that children and teens with Type 1 diabetes enrolled in an intensive remote therapy (IRT) pilot program experienced improved blood glucose control and better quality of life during the six-month study compared to those who received conventional care. The study, titled “Intensive remote monitoring vs. conventional care in type 1 diabetes: a randomized controlled trial,” was published in a recent issue of Pediatric Diabetes.
Adolescents ages 13 to 17 enrolled in the IRT program achieved a lower mean hemoglobin A1c (HbA1c) level than other children their age and younger in the program. The researchers noted that controlling T1D becomes more challenging as children enter their teen years, due to a number of physiological factors and behaviors, including hormonal changes and growing independence from parents and caregivers.
In addition to achieving improved blood sugar levels, pediatric patients and their parents reported better health-related quality of life with regard to diabetes care, despite the additional time and attention required by IRT therapy.
This study leveraged the recent advent of blood glucose monitoring systems that let users store and share their data remotely, enabling T1D patients to provide information about their blood sugar levels to their healthcare providers quickly and consistently. Patient age and program adherence played a role in achieving positive outcomes. Also, IRT participants who uploaded their data more frequently experienced better outcomes, according to the researchers.
All study participants had quarterly clinic visits, and uploaded and sent data on their blood glucose, insulin delivery and fitness activity weekly to their medical team. For the IRT group, the medical team sent a weekly email responding to the patients’ results and, if necessary would recommend a regimen adjustment. Through this ongoing communication, doctors and patients were able to identify issues and respond with care adjustments quickly, which can have significant long-term effects on patients’ health. In addition, IRT participants’ doctors noted that the clinic visits were substantially shorter than usual since issues, analysis and regimen changes were addressed on a weekly basis.
“By arming care providers with up-to-date information, families are no longer ‘flying in the dark’ with their diabetes care between appointments,” Deneen Vojta, M.D., executive vice president of research and development at UnitedHealth Group, said. “With today’s technology, healthcare professionals can provide deeply informed, high-quality care, as frequently as needed. This detailed, near-real-time care will help patients in both the short term and the long term.”
Indeed, as UnitedHealth Group officials noted, patients with T1D test their blood sugar levels several times a day and adjust their insulin dosage based on the results. However, patients meet typically with an endocrinologist only about four times per year, reviewing data retroactively and after treatment decisions may have been made. As such, this is where remote monitoring has the potential to make intervention from a health professional and subsequent adjustments more convenient, effective and efficient, and even reduce the frequency and length of clinical visits without sacrificing care.
“Innovations in diabetes technology and communications pathways allow patients to partner with their providers in Type 1 diabetes management like never before,” said Aylin Altan, senior vice president of research at OptumLabs, part of UnitedHealth Group, who analyzed the project data, and who has lived with Type 1 diabetes for more than 40 years. “If we can find a way to make maximum use of technology and collaborative decision-making with care providers, the standard of care for young patients with Type 1 diabetes will better position them to manage the disease through adulthood.”