A randomized trial comparing supplemental video care and asynchronous remote monitoring among young people with type 1 diabetes and elevated glycemic levels.

Authors

Stephanie Crossen, Salvador Lopez, Carrie Lewis, Daniel Tancredi, Amy Hughes-Lansing, Nicole Glaser

Published in

Pediatric diabetes. Volume 2026. Pages e007. Epub Aug 26, 2026.

Abstract

Telehealth can enable supplemental care to young people with type 1 diabetes (T1D) in need of frequent guidance or treatment changes. However, the relative benefits of different telehealth modalities (e.g., synchronous video visits versus asynchronous remote patient monitoring [RPM]) for specific populations remain unclear. We conducted a three-arm randomized controlled trial comparing supplemental monthly video visits or monthly RPM versus usual care over 6 months among young people aged 5-18 years with established T1D and hemoglobin A1c (HbA1c) > 8%. The study cohort of 65 participants was 57% publicly insured, with 54% White and 26% Hispanic/Latino, a mean age of 13.4 years, a T1D duration of 5.8 years, a baseline HbA1c of 9.7%, and high baseline use of continuous glucose monitoring (98%) and insulin pumps (77%). Both study arms experienced high rates of attrition (45% among video participants, 35% among RPM participants). Compared with RPM encounters, video visits were longer (mean: 29.8 vs 17.2 min, p < 0.001) and more likely to cover topics beyond insulin dose adjustments, such as diabetes behaviors, technology use, and emotional support. Intention-to-treat analysis demonstrated a trend (p = 0.06) toward 1.0% lower mean HbA1c at study completion among video participants compared with usual care, adjusting for baseline factors; no significant difference was seen for RPM. Feedback about both interventions was highly positive. These findings suggest that among young people with elevated HbA1c despite using diabetes technology, supplemental synchronous, individualized interactions may be more effective at reducing HbA1c than supplemental data review with asynchronous outreach.

PMID:
42812206
Bibliographic data and abstract were imported from PubMed on 30 Sep 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.