Telemedicine’s Impact on Diabetes Care during the COVID-19 Pandemic: A Cohort Study in a Large Integrated Healthcare System

ABSTRACT Introduction To examine if patients exposed to primary care telemedicine (telephone or video) early in the COVID-19 pandemic had higher rates of downstream HbA 1c measurement and improved HbA 1c levels in the second year of the pandemic. Research Design and Methods In a cohort of 242, 848 Kaiser Permanente Northern California patients with diabetes, we examined associations between early-pandemic patient-initiated telemedicine visit and downstream HbA 1c monitoring and results during the second year of the pandemic. Results Adjusted HbA 1c measurement rates were significantly higher among patients with telemedicine exposure in the early-pandemic prior year than those with no visits in the prior year (91.0% testing for patients with video visits, 90.5% for telephone visits, visits, 86.7% for no visits, p < 0.05). Among those with HbA 1c measured, the rates of having an HbA 1c < 8% in the second year of the COVID-19 pandemic were also statistically significantly higher among patients with telemedicine exposure in the early-pandemic prior year than those with no visits in the prior year (68.5% with HbA 1c < 8% for video visits, 67.3% for telephone visits, 66.6% for no visits, p < 0.05). Conclusions Access to telephone and video telemedicine throughout the early COVID-19 pandemic was associated with patients’ continued engagement in recommended diabetes care. Although our study analyzed telemedicine use during a pandemic, telemedicine visits may continue to support ongoing health care access and positive clinical outcomes. KEY MESSAGES The pandemic significantly increased telemedicine adoption, providing an opportunity to maintain health care access for patients with diabetes. Our study investigates the impact of telemedicine, including both telephone and video visits, on diabetes care during the early COVID-19 period. The results demonstrate that patients utilizing telemedicine exhibit higher rates of HbA 1c measurement and at-goal HbA 1c . These findings suggest that telemedicine can be a valuable tool in supporting clinical outcomes in the management of chronic health conditions.