1317-P: Improving Access and Communication through Telehealth for Pediatric Type 1 Diabetes

Telehealth may positively impact diabetes self-management by increasing contact between patients and providers. Our diabetes team developed a telehealth intervention to provide insulin adjustments and establish diabetes goals. Eligible youth had T1D, Medicaid insurance, and A1c 9-12%. Participants set goals at quarterly visits. Monthly, participants communicated glucose data with the healthcare team through EMR portal or via phone calls. Youth >10 years completed Diabetes Distress Scale (scores 1-6; higher=greater distress) and Diabetes Empowerment Scale (scores 1-5; higher=greater self-efficacy) at baseline, 6 mo, and 12 mo, while caregivers completed Diabetes Distress Scale for Parents (scores 1-5; higher=greater distress). Satisfaction surveys done at 3 and 12 mo (scores 1-5; higher=greater satisfaction). Baseline and 3 mo data presented. Youth (N=32, 56% male, 53% AA), aged 5-22 (12.4±3.9), with T1D for 5.1±3.5 years had baseline mean A1c 10.7±1.5%; 19% CSII and 34% CGM. At baseline, participants endorsed low levels of diabetes distress (mean score 1.9±0.9 youth and 2.1±0.6 parents). Youth endorsed high diabetes self-efficacy at baseline (mean score 4.2±0.6). There was no difference between mean A1c at baseline and 3 months (10.7% to 10.9%, N=26). Baseline A1c did not correlate with age, T1D duration, diabetes distress or empowerment for youth but correlated negatively with parental frustration [“I am the only one who takes responsibility for helping my teen manage diabetes” (r=-0.458; p=0.048) and “my teen ignores my suggestions about diabetes” (r=-0.842; p