Polonsky William H, Layne Jennifer E, Parkin Christopher G, Kusiak Coco M, Barleen Nathan A, Miller David P, Zisser Howard, Dixon Ronald F
Behavioral Diabetes Institute, San Diego, CA.
University of California, San Diego, San Diego, CA.
Clin Diabetes. 2020 Oct;38(4):357-362. doi: 10.2337/cd19-0105.
The Onduo Virtual Diabetes Clinic is a telehealth program for people with type 2 diabetes that combines mobile app technology, remote personalized lifestyle coaching, connected blood glucose meters, real-time continuous glucose monitoring (rtCGM) devices, and clinical support from board-certified endocrinologists. This analysis evaluated change in diabetes distress among 228 program participants who reported moderate distress (score 2.0-2.9) or high distress (score ≥3.0) on the 17-item Diabetes Distress Scale (DDS17) at enrollment. Participants reported significant reductions in overall distress from 3.0 ± 0.8 at baseline to 2.5 ± 0.9 ( <0.001) at an average of 6 months of follow-up. Significant reductions in all DDS17 subscale scores were observed; most notable were reductions in the regimen-related and emotional distress subscales (-0.9 and -0.4, respectively; both <0.001). Significantly greater reductions in overall distress ( = 0.012) and regimen-related distress ( <0.001) were reported by participants who were prescribed and used intermittent rtCGM ( = 77) versus nonusers ( = 151). Although the generalizability of these findings may be limited by the study's small sample size and potential for self-selection bias, these results do suggest that telemedicine programs such as the Onduo VDC could be a valuable tool for addressing the problem of diabetes-related distress.
Onduo虚拟糖尿病诊所是一项针对2型糖尿病患者的远程医疗项目,它结合了移动应用技术、远程个性化生活方式指导、联网血糖仪、实时连续血糖监测(rtCGM)设备以及来自获得董事会认证的内分泌学家的临床支持。本分析评估了228名项目参与者的糖尿病困扰变化情况,这些参与者在入组时在17项糖尿病困扰量表(DDS17)上报告有中度困扰(得分2.0 - 2.9)或高度困扰(得分≥3.0)。参与者报告总体困扰从基线时的3.0±0.8显著降低至平均随访6个月时的2.5±0.9(<0.001)。观察到DDS17所有子量表得分均显著降低;最显著的是与治疗方案相关的困扰子量表和情绪困扰子量表得分的降低(分别降低了0.9和0.4;均<0.001)。与未使用间歇性rtCGM的参与者(n = 151)相比,使用间歇性rtCGM的参与者(n = 77)报告总体困扰(P = 0.012)和与治疗方案相关的困扰(<0.001)有显著更大程度的降低。尽管这些发现的普遍性可能受到研究样本量小和自我选择偏差可能性的限制,但这些结果确实表明,像Onduo VDC这样的远程医疗项目可能是解决糖尿病相关困扰问题的一个有价值的工具。