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Objective: Describe baseline patient characteristics, needs, and stress of new to insulin at hospital discharge. Methods: Single site RCT to evaluate a DM Discharge Toolkit on mean 30-day glucose is ongoing among English speaking patients (pts), 21 - 80 years, with expected survival 90 days, new to insulin at discharge. Results: Among 97 eligible, 67 approached, and 40 enrolled (consent rate 60%). Mean age was 51.9 years +11.4; 55% were male; 35% had public insurance; 52% identified as black, 30% white, and 22% Hispanic/Latino, with 23 (58%) prior DM. Mean glucose was 374 u+/u213 and median HbA1C 11.4 9.6, 13.3. Nearly 30% had limited literacy (Single Item Literacy Screener, 2), though 90% had home internet and reported its use for health information. Acceptability of research continuous glucose meter (CGM) at discharge was high (48%). Stress was also high, over 60% reported elevated perceived stress (Perceived Stress Scale u/u14), 35% with prior DM reported elevated DM distress (Diabetes Distress Score u /u2.0). A majority (60%) had u/u 1 health-related social need (HRSN), 12.5% had 3; food insecurity (22.5%), transportation (15%) and medication affordability (12.5%) were highest. Conclusion: Our medically/socially complex cohort of DM patients consented to RCT, including many of minority race/ethnicity. These patients have high levels of disease and non-disease specific stress and multiple HRSN that could affect safe insulin delivery. Interestingly, most accessed and used technology/internet, and were open to DM technology (CGM). Achieving better glycemic control in our sickest patients demands comprehensive, multi-modal interventions which can leverage DM technology to enhance care delivery. Disclosure K. Lee: None. C.M. Smyrniotis: None. C.A. Clingan: None. K.M.V. Carthy: None. C. Coventry: None. K. Davis: None. S.J. Freeman: None. J.J. Lee: None. J. Song: None. J.L. Holl: None. S. Bailey: Consultant; Gilead Sciences, Inc. Research Support; Gilead Sciences, Inc., Pfizer Inc., Merck Sharp Lundbeck. A. Wallia: Research Support; UnitedHealth Group, Novo Nordisk. Funding R18 HS026143, NIH/AHRQ
LEE et al. (Fri,) studied this question.