2101-P: eCare School Health: A Novel Telehealth-Based Intervention for Type 1 Diabetes Management at School

Introduction and Objective: Youth with type 1 diabetes (T1D) require consistent glycemic monitoring and insulin administration during the school day. However, the national shortage of school nurses creates a gap in diabetes care in youth with T1D during school hours.1,2 Telehealth-based interventions have been shown to improve clinical outcomes in youth with T1D.3-6 Avel eCare School Health (eCare) is a telemedicine service that provides access to virtual school nurses who assist with required care plans, glucose monitoring, and insulin dosing. The objective of this study was to evaluate the effectiveness of the eCare program on HbA1c and diabetes management in students with T1D. Methods: Youth aged 3-17 years with physician-diagnosed T1D, attending schools served by eCare, were included. Clinical outcomes included HbA1c values and parent-reported diabetes management questionnaire (DMQ) scores obtained at program implementation, then every 4-6 months until the end of the study. Historical HbA1c values up to 18 months before implementation were obtained by medical record abstraction. Longitudinal mixed-effect models were conducted and adjusted for child’s age, maternal education, insurance status, and T1D duration. All statistical analyses were performed using SAS v9.4. Results: Fifty-four youth were included in the HbA1c analysis (~14 values/youth), and 47 child/parent pairs were included in the DMQ analysis (~5 collections/youth). On average, HbA1c decreased 0.9% after program implementation (β=0.90; 95% CI: 0.64-1.17), and this improvement was sustained over time. Participation in the eCare program improved parent-reported DMQ scores; each day the student participated, the parent's DMQ score increased (β=0.005; 95% CI: 0.001-0.009). Conclusion: This study supports the utilization of telehealth school nursing services to improve diabetes care and management among children with T1D and their parents. These services provide an alternative solution for rural or underserved schools to support their students with T1D. Disclosure M.G. Moulton: None. K. Ziegler: None. C.W. dos Reis: None. M.L. Bell: None. S. Freed: None. C. Hockett: None. Funding BreakthroughT1D and Helmsley Charitable Trust (3-SRA-2022-1106-S-B)