Objectives:

The reimbursement of telehealth has expanded during the COVID-19 pandemic to reduce exposure for both patients and providers. We aimed to evaluate the effects of using telehealth during the pandemic on diabetes care in Louisiana.

Methods:

We used electronic health records from the Research Action for Health Network (REACHnet) database to select patients with type 2 diabetes. The study included two-year pre-period (February 2018 to February 2020) and one-year post-period (March 2020 to February 2021). The treatment cohort was defined as patients who used any telehealth since March 1^st, 2020. Others were assigned in the control group. Propensity score weighting was used to obtain comparable treatment and control groups at two-year baseline. We then used a difference-in-difference (DID) approach to compare glycemic control measured by HbA1c and other clinical measures (low-density lipoprotein [LDL], systolic blood pressure [SBP], diastolic blood pressure [DBP], body mass index [BMI]) between telehealth users and non-telehealth users.

Results:

We included 12,811 patients in the treatment group and 18,520 patients in the control group to evaluate glycemic control. Compared with patients that did not receive telehealth during the pandemic, patients receiving any telehealth had a mean reduction in HbA1c of 0.065 % (p<0.05). Receiving any telehealth decreased the percentage of patients having HbA1c over 7% by 1.8 percentage points (p<0.05). We also found that receiving any telehealth service was associated with a reduction in LDL of 0.931 mg/dL (p<0.05), and a decrease in BMI of 0.107 kg/m² (p<0.05). We found no significant improvement in SBP and DBP.

Conclusions:

This study found clinical benefits of using telehealth in glycemic control and some other clinical measures in diabetes care. Factors unmeasured in this study would need to be further explored to truly understand the impact of telehealth.