Comparison of Glycemic Control Between In-Person and Virtual Diabetes Consults in Hospitalized Patients With Diabetes

Maria Gracia Luzuriaga; Monica Lieberman; Ruixuan Ma; Sabina Casula; Violet Lagari-Libhaber; Shari Messinger; Hua Li; Bresta Miranda; David A Baidal; Ernesto Bernal Mizrachi; Gianluca Iacobellis; Rajesh Garg; Francesco Vendrame

doi:10.1177/19322968231199470

Comparison of Glycemic Control Between In-Person and Virtual Diabetes Consults in Hospitalized Patients With Diabetes

J Diabetes Sci Technol. 2023 Sep 20:19322968231199470. doi: 10.1177/19322968231199470. Online ahead of print.

Authors

Maria Gracia Luzuriaga^{1

2}, Monica Lieberman³, Ruixuan Ma⁴, Sabina Casula⁵, Violet Lagari-Libhaber^{1

5}, Shari Messinger², Hua Li², Bresta Miranda¹, David A Baidal¹, Ernesto Bernal Mizrachi^{1

5}, Gianluca Iacobellis¹, Rajesh Garg^{1

6}, Francesco Vendrame¹

Affiliations

¹ Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL, USA.
² Department of Endocrinology, Diabetes and Metabolism, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA.
³ Jackson Memorial Hospital, Miami, FL, USA.
⁴ Division of Biostatistics, Department of Epidemiology and Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA.
⁵ Endocrinology Section, Miami Veterans Affairs Healthcare System, Miami, FL, USA.
⁶ Harbor-UCLA Medical Center, Torrance, CA, USA.

PMID: 37727950
DOI: 10.1177/19322968231199470

Abstract

Background: There is limited evidence that the diabetes in-person consult in hospitalized patients can be replaced by a virtual consult. During COVID-19 pandemic, the diabetes in-person consult service at the University of Miami and Miami Veterans Affairs Healthcare System transitioned to a virtual model. The aim of this study was to assess the impact of telemedicine on glycemic control after this transition.

Methods: We retrospectively analyzed glucose metrics from in-person consults (In-person) during January 16 to March 14, 2020 and virtual consults during March 15 to May 14, 2020. Data from virtual consults were analyzed by separating patients infected with COVID-19, who were seen only virtually (Virtual-COVID-19-Pos), and patients who were not infected (Virtual-COVID-19-Neg), or by combining the two groups (Virtual-All).

Results: Patient-day-weighted blood glucose was not significantly different between In-person, Virtual-All, and Virtual-COVID-19-Neg, but Virtual-COVID-19-Pos had significantly higher mean ± SD blood glucose (mg/dL) compared with others (206.7 ± 49.6 In-person, 214.6 ± 56.2 Virtual-All, 206.5 ± 57.2 Virtual-COVID-19-Neg, 229.7 ± 51.6 Virtual-COVID-19-Pos; P = .015). A significantly less percentage of patients in this group also achieved a mean ± SD glucose target of 140 to 180 mg/dL (23.8 ± 22.5 In-person, 21.5 ± 20.5 Virtual-All, 25.3 ± 20.8 Virtual-COVID-19-Neg, and 14.4±18.1 Virtual-COVID-19-Pos, P = .024), but there was no significant difference between In-person, Virtual-All, and Virtual-COVID-19-Neg. The occurrence of hypoglycemia was not significantly different among groups.

Conclusions: In-person and virtual consults delivered by a diabetes team at an academic institution were not associated with significant differences in glycemic control. These real-world data suggest that telemedicine could be used for in-patient diabetes management, although additional studies are needed to better assess clinical outcomes and safety.

Keywords: COVID-19; diabetes mellitus; hospital; telemedicine.