Provider-Initiated Regular Remote Interventions for Optimal Type 2 Diabetes Care

Emerging data suggests that clinical interventions may be implemented successfully by a variety of remote communications. Thus far regular monitoring and treatment adjustments by remote communications have not yet been fully integrated into endocrine practice in a scalable fashion that can be readily disseminated. The PI proposes to test a new endocrine model care clinic for high-risk patients with type 2 diabetes that employs regular communications initiated by the provider, based on a tailored individual plan. Frequent monitoring and interventions will reinforce attainment of prespecified therapy goals, enhance patient engagement, and allow a significant decrease in the frequency of outpatient visits. In turn, the clinic will be able to accommodate more patients with type 2 diabetes than traditional endocrine clinics. Data management and day-to-day clinic operation will be computerized with technology that has been developed by the institution. The project is highly significant since it proposes a new model of endocrine care for high-risk patients with type 2 diabetes that may improved disease outcome in more patients and reduce medical expenses.

Inclusion criteria

• Men or women aged ≥18 years of age;
• Clinical diagnosis of type 2 diabetes (as defined by the American Diabetes Association 2);
• Treated with insulin or at least two diabetes medications;
• Have A1C ≥8.0% and ≤11.0%;
• Able and willing to use telephone or other sorts of communication regularly between clinic visits.

Exclusion criteria

• Do not speak English;
• Unwilling or unable to provide informed consent;
• Have any condition associated with life expectancy of less than 3 years;
• Have an active mental illness or substance abuse