Glycemic control
Diabetes
RECRUITMENT, DIABETES
This study was designed primarily to evaluate the feasibility and acceptability of RPM, and therefore was not powered to detect significant changes in glycemic control. However, given the availability of CGM data for all participants, we were able to generate preliminary estimates of the glycemic effects of RPM within our cohort. Glycemic management indicator (GMI) was used as the main indicator of glycemic control for study participants due to a high frequency of telehealth visits (at which hemoglobin A1c levels were not routinely measured) during the study period. GMI is a method of assessing glycemic control from CGM data, previously referred to as an “estimated A1c” (To isolate the effects of the intervention from any expected glycemic changes in its absence, we employed a non-randomized control group for this analysis. The research team made note of patients who met all enrollment criteria and had clinic appointments during the enrollment period but were not contacted for study recruitment due to limited research staff availability. Among these, a subset was already sharing CGM data to the UCDH Pediatric Diabetes clinic Due to our expectation that treatment effects would vary based on participants’ level of glycemic control at study entry, we also stratified our analysis by baseline GMI quartile. This was accomplished by adding baseline GMI quartile to the model as an interaction term with the time and exposure variables, allowing the direction of change across timepoints to vary between quartiles. All participants with available CGM data were included in the glycemic analyses regardless of whether or how much they received outreach during the intervention period, in accordance with intention-to-treat principles. All statistical analyses were performed using Stata/SE version 17.0 for Windows (