Improved glucose control for people with diabetes who enrolled in a multi-chronic condition remote monitoring platform

Liu, S.; Painter, S. L.; James, R.; Kompala, T.; Shah, B.

Background: Remote monitoring platforms (RMP) with personalized coaching continue to scale and have shown to be an effective tool for self-monitoring blood glucose (BG) and blood pressure (BP) for individuals with diabetes (DM) and hypertension (HTN). With HTN being a common risk factor for individuals with DM, it's important to understand how RMPs can support individuals with both DM and HTN. Methods: Members were enrolled in a multi-chronic condition RMP with access to both DM and HTN programs. Using Propensity Score Matching to ensure no statistical differences in age, gender, race, DM type, insulin dependence, self-reported HbA1c, median zip code income, and zip code, two sample populations were constructed of those who were enrolled in DM only and DM+HTN between 1/1/2019 and 6/30/2019 and active on the platform for at least 1 year. For robust results, Bootstrapped Propensity Score Matching was used with 2,000 iterations. Paired t-test was used to compare reduction in estimated a1c at 6-and 9-months. Due to COVID-19, outcomes at 12-months were not evaluated. Results: No statistical differences between DM only (n=888) and DM+HTN (n=888) groups in age (56 vs. 56), gender (50% vs. 48% female), race (59% vs. 62% Caucasian), diabetes type (95% vs. 95% T2DM), insulin dependent (24% vs. 27%), started uncontrolled (49% vs. 50%), and self-reported HbA1c at time of registration (7.3% vs. 7.3%). Average estimated HbA1c reductions at 6 months were -0.46% for DM only and -0.65% for DM+HTN (p = 0.011). Reduction was similar at 9-month though no longer statistically different with values of -0.42% vs. -0.57%, respectively. Conclusions: Members enrolled in both DM+HTN versus DM only had improved glucose control within 6-months indicating RMPs that support multiple chronic conditions may have better outcomes. Future study is required to better understand the drivers of the clinical improvement for multiple conditions.