Improving Diabetic Care Through Education and Innovation.

Despite the innovative advancements in diabetes care, providers may not recognize patients with type 2 diabetes mellitus (T2DM) who qualify for a continuous glucose monitoring (CGM) device or the benefits of a telemedicine program for improving self-management behaviors. This quality improvement (QI) project aimed to determine if an advanced practice registered nurse (APRN)-led telemedicine program using CGM could improve glycemic control and self-management in patients with insulin-dependent T2DM. A 6-week telemedicine program was developed and implemented using the CGM's time-in-range to deliver patient-specific education. Clinical metrics were collected at each visit. All patients completed a pre- and postintervention Diabetes Self-Management Questionnaire-Revised (DSMQ-R) survey. A repeated measures analysis of variance revealed that the telemedicine program had a statistically significant impact on time-in-range outcomes, (2, 14) = 18.203, < .001. Paired-samples tests indicate that APRN-led education improved body mass index, (8) = 4.232, = .002; decreased systolic blood pressure, (8) = 2.90, = .010, and diastolic blood pressure, (8) = 3.21, = .007; and increased self-management skills as evidenced by DSMQ-R, (8) = -5.498, < .001. This QI project highlights multiple interventions for improving diabetes management in a primary care facility. An APRN-led telemedicine program integrating CGM time-in-range data can improve glycemic control and self-management skills in patients with T2DM who administer insulin.