Gaining Glycemic Control in Patients with Uncontrolled Type 2 Diabetes in Rural Health

Practice Problem: Diabetes is a significant global healthcare problem. The number of individuals diagnosed with Type 2 Diabetes (T2D) is alarmingly high and the numbers are steadily increasing. Because of various barriers, individuals living in rural communities are at greater risk of having uncontrolled T2D. PICOT: The PICOT question that guided this project was “Will patients with uncontrolled T2D in rural health have better control of their glucose levels when using telephone or web-based monitoring by healthcare providers than patients with uncontrolled T2D in rural health who do not use technology to achieve glycemic control as evidenced by lower pre-prandial blood glucose levels over 8 weeks?” Evidence: Evidence indicates that implementing telehealth strategies significantly lowers pre-prandial blood glucose levels in patients with uncontrolled T2D in rural participants. Intervention: Telemedicine was utilized as an innovative approach to coach and monitor patients in efforts to gain glycemic control. Coaching provided nutritional intake for meal planning, dietary tips to modify diet, and various low-impact exercises to increase physical activity; monitoring motivated patients to keep a daily log of their fasting blood sugars and assessed accountability. Outcome: The goal was to have a 25% reduction in fasting blood sugars in participants using the intervention, but findings surpassed that with a 45% reduction in pre-prandial glucose using telemedicine. Conclusion: Using telemedicine to gain glycemic control is statistically and clinically significant. This innovative approach not only improves health outcomes, but it increases access to care for those living in rural communities.