Introduction and Objective: Remote patient monitoring (RPM) is increasingly integrated into diabetes care, yet engagement patterns remain incompletely described in pragmatic trials. The present analysis characterized RPM engagement, adherence, and alert burden in a factorial optimization trial. Methods: This descriptive analysis included Black adults with uncontrolled type 2 diabetes (T2D) randomized to receive RPM using a cellular-enabled glucometer transmitting blood glucose (BG) readings in real time across healthcare systems in Alabama and Mississippi. Adherence was defined as recording ≥16 monitoring days in any 30-day cycle during the six-month period. Engagement intensity and alert burden were summarized overall and by intervention arm. Red alerts were defined as BG 450 mg/dL or 70 mg/dL; yellow alerts as BG 250-449 mg/dL. Results: Among 117 participants with available RPM data (mean age 54.7±11.0 years, 69.2% female, mean HbA1c 10.0±1.7%), 75.2% met the adherence threshold in at least one 30-day cycle, with similar adherence across intervention combinations (70.0-82.8%). Participants recorded BG data on a mean of 16.1±7.3 days/month (31.9±20.8 readings/month; 1.06±0.69 readings/day). Most participants (82.9%) experienced at least one critical alert.The mean number of critical alerts in the six months period was 25.6±34.3 (median 11; IQR 2-34), including a mean of 4.8±11.2 red and 20.8±29.5 yellow alerts. Daily BG monitoring for a full 30-day cycle occurred in 20.5% of participants at least once. Conclusion: In this multisite trial of Black adults with uncontrolled T2D, RPM engagement was common despite variable day-to-day use. Clinically significant alerts were frequent, suggesting that flexible RPM use can still generate actionable clinical information. Disclosure A. El Zein: None. L. Ghazi: None. T. Nawshin: None. E. Wallace: Consultant; Ended; Sanofi, Chiesi USA, Inc. Research Support; Ended; Chiesi USA, Inc. Consultant; Ended; Sangamo Therapeutics, Inc. Research Support; Ended; Idorsia Pharmaceuticals Ltd. Other - Speaker for educational activities but not part of a bureau; Ended; Natera. Consultant; Ended; Inceptive Therapeutics. Research Support; Ended; uniQure, Amicus Therapeutics, Inc. V.V. Garla: None. T. Mehta: None.
Zein et al. (Fri,) studied this question.