Program completion and glycemic control in a remote patient monitoring program for diabetes management: Does gender matter?

Tzeyu L Michaud; Mohammad Siahpush; Keyonna M King; Athena K Ramos; Regina E Robbins; Robert J Schwab; Martina A Clarke; Dejun Su

doi:10.1016/j.diabres.2019.107944

Program completion and glycemic control in a remote patient monitoring program for diabetes management: Does gender matter?

Diabetes Res Clin Pract. 2020 Jan:159:107944. doi: 10.1016/j.diabres.2019.107944. Epub 2019 Nov 23.

Authors

Tzeyu L Michaud¹, Mohammad Siahpush², Keyonna M King³, Athena K Ramos⁴, Regina E Robbins², Robert J Schwab⁵, Martina A Clarke⁶, Dejun Su³

Affiliations

¹ Center for Reducing Health Disparities, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA; Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA. Electronic address: tzeyu.michaud@unmc.edu.
² Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA.
³ Center for Reducing Health Disparities, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA; Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA.
⁴ Center for Reducing Health Disparities, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA.
⁵ Division of General Internal Medicine, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA.
⁶ Division of Cardiovascular Medicine, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA.

PMID: 31765684
DOI: 10.1016/j.diabres.2019.107944

Abstract

Aims: To examine gender differences in program completion and glycemic outcomes for patients with type 2 diabetes (T2D) in a remote patient monitoring (RPM) program for diabetes management.

Methods: Based on data from an RPM program that enrolled post-discharge T2D patients (n = 1645) in 2014-2017, logistic regression models were estimated to assess gender difference in the likelihood of completing the three-month RPM program; whereas ordinary least squares (OLS) regression models were used to examine gender difference in post-RPM hemoglobin A1c (HbA1c), controlling for demographics, baseline health status, including HbA1c, patient activation scores, and physiological data upload frequency for patients who had completed the program.

Results: Among enrolled participants, men had lower odds of completing the three-month RPM program than women (adjusted odds ratio, 0.61; 95% confidence interval [CI], 0.39-0.95). However, among those who completed the program, men had lower post-RPM HbA1c than women (-0.18; 95% CI, -0.33, -0.03) after controlling for baseline HbA1c and other covariates.

Conclusions: While female patients with T2D were more likely to complete the RPM program, they showed a higher glycemic level at the end of the program compared to male patients. To close gender disparities in health, interventions through telemedicine tailored towards women's diabetes outcomes and men's engagement level are warranted.

Keywords: Engagement; Gender disparities; HbA1c; Program participation; Telemedicine; Type 2 diabetes.

MeSH terms

Diabetes Mellitus, Type 2 / therapy*
Female
Gender Identity*
Glycated Hemoglobin / analysis
Glycated Hemoglobin / metabolism*
Humans
Male
Middle Aged
Monitoring, Physiologic / methods*
Retrospective Studies
Telemedicine / methods*

Substances

Glycated Hemoglobin A