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Notable Publication: Assessing Patterns of Diabetes Self-Management Education and Support Among Adults Using Telemedicine

February 1, 2024

UPMC Division of Endocrinology and Metabolism faculty recently published a notable research article in the Journal of Diabetes Science and Technology that assessed patterns of Diabetes Self-Management Education and Support (DSMES) over two years among adults who used telemedicine for type 2 diabetes (T2D) endocrinology care.

Division faculty included in the publication are Jason Ng, MD, and Margaret Zupa, MD, MS, as well as colleagues from the University of Pittsburgh Division of General Internal Medicine.

Background: Population health management approaches can help target diabetes resources like DSMES to individuals at the highest risk of complications and poor outcomes. However, due to the increase in telemedicine usage for diabetes care during the COIVD-19 pandemic, there is little evidence about patient characteristics associated with DSMES receipt.

Methods: In this retrospective cohort study, researchers used electronic medical record data to assess patterns of DSMES delivery from May 2020 to May 2022 among T2D patients in a large integrated health system who used telemedicine services. Multilevel regression models were used to evaluate the association of key patient characteristics with DSMES receipt.

Results: A total of 401 patients (11%) out of the 3,530 patient cohort received DSMES. In adjusted multivariable logistic regression, higher baseline HbA1c, insulin regimen complexity, and number of noninsulin medications were significantly associated with receipt of DSMES. Two factors which may impact access to specialty diabetes care, rurality and area-level deprivation of patient residence, were not significantly associated with receipt of DSMES.

Conclusion: The research team concluded that DSMES remains underutilized in the cohort of adults using telemedicine to access endocrinology care for T2D. There is great potential for a new population health management approach using EMR data, which could target DSMES resources to those at a higher risk of poor outcomes.

View the full study.


Bober T, Rothenberger S, Lin J, Ng JM, Zupa M. Factors Associated With Receipt of Diabetes Self-Management Education and Support for Type 2 Diabetes: Potential for a Population Health Management Approach. J Diabetes Sci Technol. 2023 Sep;17(5):1198-1205. doi: 10.1177/19322968231176303. Epub 2023 Jun 1. PMID: 37264614; PMCID: PMC10563527.