JMIR Publications

ABSTRACT

Background:

Multidisciplinary remote patient monitoring (RPM) programs may improve diabetes management by enabling continuous glucose monitoring and timely treatment adjustments. Evidence describing real-world implementation of RPM programs in high-risk populations remains limited.

Objective:

This study evaluated clinical outcomes of a multidisciplinary RPM program for patients with uncontrolled type 2 diabetes mellitus (T2DM).

Methods:

Adults with T2DM, hemoglobin A1c (HbA1c) > 7%, and insulin therapy who enrolled in an RPM program at the University of Mississippi Medical Center between July 2020 and December 2022 were included. Patients received a Bluetooth-enabled glucometer and structured follow-up from nurses and pharmacists operating under a collaborative practice agreement. A propensity score–matched control group receiving usual outpatient care was identified. The primary outcome was change in HbA1c. Secondary outcomes included hospitalizations, program engagement, and medication adjustments.

Results:

Among 109 RPM patients, mean HbA1c decreased from 10.79% to 8.85% (−1.94%). Fifty-eight patients completed at least one structured glucose review and were considered active participants; 54 were matched to controls. In the matched cohort, HbA1c decreased by −2.53% among RPM participants compared with −1.97% in controls, although the between-group difference was not statistically significant (p=0.278). Participants who completed the RPM program achieved the largest HbA1c reductions (−3.34%). Hospitalizations occurred in 14.8% of RPM participants versus 18.5% of matched controls.

Conclusions:

Multidisciplinary RPM integrating nurses, pharmacists, and physician oversight was associated with improvements in glycemic control among high-risk T2DM patients. Greater program engagement was associated with larger HbA1c reductions, suggesting RPM may represent a scalable approach to improving diabetes care in medically underserved populations.