Kinan Kassar1, Cheryl Roe1, Marisa Desimone1. 1. Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, SUNY Upstate Medical University , Syracuse, New York.
Abstract
BACKGROUND: Prisoners can have difficulty obtaining subspecialty consultations. Telemedicine is used to provide diabetes consultations for residents of correctional facilities from our diabetes center. Telemedicine helps improve access to endocrinologists at reduced cost, but little outcome data are available. METHODS: A retrospective chart review of prisoners from 15 correctional facilities who received televisits for diabetes from 2011 to 2014 was performed. Demographic information, complications, medications, blood pressure, and laboratory results were collected. RESULTS: At baseline (n = 106), mean age was 44 years, duration of diabetes was 15 years, 44% had type 1 diabetes, and all were male. Only 64 of the participants had ≥2 video consultations; 58/64 had follow-up HbA1c results; and 53/58 were insulin requiring. Mean initial HbA1c was 9.3% with an average decrease of 0.5% from initial to final visit (a mean of 3.6 televisits). Patients with an initial HbA1c >9% (n = 28) had an average drop of 1.3%. Twenty-two subjects had initial elevated blood pressure; 20/22 (91%) were prescribed angiotensin-converting-enzyme-inhibitors (ACE-I)/angiotensin II receptor blockers (ARB); and 15 of these 20 (75%) had a final blood pressure <140/90 mm Hg over a mean of 3.3 televisits. 17/20 with high low-density lipoprotein (LDL) were treated with statin drugs; 15/17 (88%) had improved LDL on follow-up. Follow-up was limited by prisoner availability or visit cancellation by prison facility. CONCLUSION: Improvements in glycemic, blood pressure, and lipid control for prisoners with diabetes can be achieved with teleconsultations to correctional institutions. Given the high costs of transporting prisoners to healthcare facilities, telemedicine should be considered to help improve diabetes care for this vulnerable population.
BACKGROUND: Prisoners can have difficulty obtaining subspecialty consultations. Telemedicine is used to provide diabetes consultations for residents of correctional facilities from our diabetes center. Telemedicine helps improve access to endocrinologists at reduced cost, but little outcome data are available. METHODS: A retrospective chart review of prisoners from 15 correctional facilities who received televisits for diabetes from 2011 to 2014 was performed. Demographic information, complications, medications, blood pressure, and laboratory results were collected. RESULTS: At baseline (n = 106), mean age was 44 years, duration of diabetes was 15 years, 44% had type 1 diabetes, and all were male. Only 64 of the participants had ≥2 video consultations; 58/64 had follow-up HbA1c results; and 53/58 were insulin requiring. Mean initial HbA1c was 9.3% with an average decrease of 0.5% from initial to final visit (a mean of 3.6 televisits). Patients with an initial HbA1c >9% (n = 28) had an average drop of 1.3%. Twenty-two subjects had initial elevated blood pressure; 20/22 (91%) were prescribed angiotensin-converting-enzyme-inhibitors (ACE-I)/angiotensin II receptor blockers (ARB); and 15 of these 20 (75%) had a final blood pressure <140/90 mm Hg over a mean of 3.3 televisits. 17/20 with high low-density lipoprotein (LDL) were treated with statin drugs; 15/17 (88%) had improved LDL on follow-up. Follow-up was limited by prisoner availability or visit cancellation by prison facility. CONCLUSION: Improvements in glycemic, blood pressure, and lipid control for prisoners with diabetes can be achieved with teleconsultations to correctional institutions. Given the high costs of transporting prisoners to healthcare facilities, telemedicine should be considered to help improve diabetes care for this vulnerable population.
Authors: Jorge Muriel Fernandez; María José Sánchez Ledesma; Manuel López Millan; María Begoña García Cenador Journal: J Med Syst Date: 2017-03-27 Impact factor: 4.460
Authors: Thomas L Keller; Jennifer Wright; Lucas M Donovan; Laura J Spece; Kevin Duan; Nadiyah Sulayman; Alexandria Dominitz; J Randall Curtis; David H Au; Laura C Feemster Journal: Chronic Obstr Pulm Dis Date: 2022-01-27
Authors: Matthew F Bouchonville; Margaret M Paul; John Billings; Jessica B Kirk; Sanjeev Arora Journal: Curr Diab Rep Date: 2016-10 Impact factor: 4.810
Authors: Abby Rowlands; Melissa Fisher; Jyoti Mishra; Mor Nahum; Benjamin Brandrett; Michael Reinke; Michael Caldwell; Kent A Kiehl; Sophia Vinogradov Journal: Front Psychiatry Date: 2020-04-15 Impact factor: 4.157