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What to Know About Telemedicine for Type 2 Diabetes

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What to Know About Telemedicine for Type 2 Diabetes

The ongoing COVID-19 pandemic has changed our day-to-day lives. Most people are staying home more than usual. Work, school, and even doctor visits have been moved online.

While virtual doctor visits, also known as telemedicine or telehealth, aren’t really a new concept, they have become even more crucial and widely received during the pandemic.

Fortunately, new federal rules allow providers to use telehealth for routine appointments without as many restrictions as in the past.

For someone living with type 2 diabetes, virtual healthcare visits and telehealth tools can be extremely useful. Doctors can monitor blood glucose, diet, and overall health virtually. They can also ensure you’re getting the medications you need, even if they aren’t seeing you in person.

Here are a few tips and tricks to help you get the most out of a telehealth visit for diabetes, plus when it might be best to schedule an in-person visit instead.

You might think that telehealth simply means holding a doctor’s appointment via video conferencing platforms (like FaceTime, Skype, or Zoom) or over the phone. But telehealth actually encompasses much more than that.

Along with the virtual visits, telehealth can also include:

  • monitoring vital signs remotely through phone apps or other technologies
  • emailing, texting, voicemail messaging, or other electronic interactions with healthcare providers
  • using an online portal to check test results
  • sharing of exam notes and test results between medical offices
  • setting up email or text reminders when you’re due for screenings, checkups, or prescription refills

Getting routine checkups is an important part of managing diabetes. The Centers for Disease Control and Prevention (CDC) recommends that you visit your doctor at least every 3 months if you’re having trouble meeting your treatment goals, or every 6 months if you’re meeting your treatment goals.

Regular checkups allow your doctor to track your condition and, if necessary, make changes to your treatment plan.

If you’ve been putting off seeing your doctor due to the pandemic, or if you’re having trouble managing your diabetes, consider scheduling a telehealth visit right away.

It’s important to prepare ahead of a remote visit to ensure it goes well. If your doctor uses video conferencing software or an app for the meeting, you’ll need a smartphone or tablet as well as internet access.

Here is what you should to do before your appointment:

  • make a list of your medications
  • take note of any prescriptions that need to be refilled
  • prepare a list of questions you want to ask
  • take your blood pressure and measure your weight (if possible)
  • download data from your blood glucose meter, insulin pump, or continuous glucose monitor (CGM); refer to the instructions provided by the manufacturer of your device for assistance, or ask your provider for help in advance as you may have to share an access code with them
  • fill out any necessary paperwork electronically; or print it, fill it out, and fax it back to your provider before the appointment

Lastly, be sure to set up your computer or phone for the meeting in a quiet, private setting with good lighting and a strong internet connection. You may want to test your internet connection before your scheduled appointment.

Your doctor may ask a variety of questions about your lifestyle, medications, and overall health, including questions about:

  • how you’ve been self-monitoring your blood sugar
  • the frequency and severity of episodes of hypoglycemia (low blood sugar) or hyperglycemia (high blood sugar)
  • any recent lab work you’ve had
  • your current weight (if you have a scale at home to weigh yourself)
  • your diet and exercise habits
  • your medication use
  • any symptoms of nerve damage, such as numbness
  • any lifestyle changes
  • your tobacco and alcohol use
  • any symptoms of depression or other psychological concerns

If you haven’t done so already, your healthcare provider may set you up with a telehealth system that allows you to easily track daily blood glucose readings and send them to your doctor’s office. A nurse or other provider can use these readings to make treatment changes when necessary.

During the appointment, your doctor can answer any questions you have about managing diabetes and prioritizing self-care. Based on the information you’ve provided, your doctor may then discuss any dietary modifications or medication changes that need to be made going forward.

Your doctor may also follow up with educational resources in the form of pamphlets or helpful videos or tutorials.

Doctors are realizing the added benefits of telehealth for people living with diabetes more and more each day.

A review of studies found that telehealth interventions result in significantly improved blood glucose control compared to typical care interventions. A 2018 study found that diabetes care delivered via telemedicine is safe and saved both time and costs for veterans with type 1 diabetes who live in rural areas.

There are many benefits of telehealth when it comes to diabetes care. It provides:

  • round-the-clock monitoring of your condition and blood sugar levels
  • support for people who live in rural areas and can’t make it to a doctor’s office often
  • the ability for more frequent check ins, as these visits don’t require travel
  • quick access to treatment for depression and other psychological issues when necessary
  • potential cost savings, as virtual visits may be less expensive for the patient and can reduce healthcare costs for providers and payers
  • savings on transportation time and cost by conducting the visit from the comfort of your own home
  • digital health tools, such as smartphone apps, for continuous support when it comes to engaging in a healthy diet and exercise routine
  • protection from healthcare environments that carry a risk of acquiring infections

Telehealth isn’t perfect and is no substitute for complete care, especially if you’re experiencing any new symptoms or having a hard time controlling your blood sugar. There are some downsides of telehealth for diabetes care:

  • Your doctor won’t be able to thoroughly examine your skin, feet, and injection sites.
  • Your doctor won’t be able to do imaging tests and blood work, the same day in the office.
  • Your doctor won’t be able to check your blood pressure, unless you’re able to do so at home and share readings.
  • Some specialist appointments for comorbid conditions must occur in person, such as ophthalmology visits.
  • There is some concern about privacy for patient data that’s submitted electronically.
  • Not everyone has access to the technology that’s necessary to conduct a telehealth visit, such as a smartphone, computer, or tablet with a camera and audio.
  • Though many insurance companies are changing their policies to include coverage for telehealth, some services may not be covered, and you may have to pay more out of pocket.

Some aspects of diabetes care aren’t possible to do remotely. If you’re experiencing any complications or having difficulty managing your diabetes, you may need to see a specialist in person.

Diabetes can cause problems with the eyes, kidney, and nerves, and can lead to open sores on the feet. These complications may get worse over time. So it’s important to get these things evaluated in person and treated.

You may also want to consider an in-person appointment if you’re having frequent episodes of low blood sugar (hypoglycemia).

Emergency symptoms

Low blood sugar, or hypoglycemia, can occur in people living with diabetes when they take too much of their medication, don’t eat enough, eat erratically, drink alcohol without food, or exercise more than normal. Hypoglycemia can develop into an emergency quickly if not treated right away.

It’s important to know the signs and symptoms of hypoglycemia and understand how to address it on your own. These signs include:

  • trouble thinking clearly
  • blurred vision
  • sudden fatigue
  • shakiness
  • speaking difficulties
  • increased thirst
  • extreme and sudden hunger
  • nausea
  • sweating or clammy palms
  • dizziness
  • loss of consciousness
  • seizure
  • coma

The best way to treat a hypoglycemic episode is with a small, high carbohydrate snack, like juice, gummy candies, or cookies. It is usually recommended to have 15 grams of carbohydrates and then rechecking your blood sugar in 15 minutes to ensure it has normalized.

If your symptoms worsen or don’t get better after self-treating, call 911 or your local emergency services. They may be able to treat hypoglycemia without taking you to the emergency room. Your family member can also administer an emergency injection of glucagon to raise your blood sugar while you wait for emergency services to arrive.

Telemedicine has long been useful for diabetes care. In fact, the technology used to monitor and report blood sugar changes directly to your doctor has existed for years prior to the current pandemic and is likely here to stay.

In the age of COVID-19, telehealth has become increasingly valuable, as people living with diabetes are considered high risk and should avoid in-person appointments whenever possible.

If you’re due for a diabetes checkup, contact your doctor to find out if they offer telehealth appointments.

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