Remote glucose monitoring is feasible for patients and providers using a commercially available population health platform
Open accessAbstract
Objective: Remote patient monitoring (RPM) holds potential to enable more individualized and effective care for patients with type 1 diabetes (T1D), but requires population analytics to focus limited clinical resources on patients most in need. We explored the feasibility of RPM from patient and provider standpoints using a commercially available data analytic platform (glooko Population Health) among a cohort of youth with T1D. Study design: Patients aged 1-20 years with established T1D (≥12 months) and CGM use (≥3 months) were recruited to participate. Participants’ CGM devices were connected to the glooko app and linked to the research team’s glooko account during a one-month baseline period. This was followed by a six-month intervention period during which participants with >15% of glucose values >250 mg/dl or >5% of values <70 mg/dl each month were contacted with personalized diabetes management recommendations. Participants were surveyed about their experiences, and effects on glycemic control were estimated via change in glucose management indicator (GMI) generated from CGM data at baseline and completion. Changes in time spent within various glucose ranges were also evaluated, and all glycemic metrics were compared to a non-randomized control group via difference-in-difference regression, adjusting for baseline characteristics. Results: Remote data-sharing was successful for 36 of 39 participants (92%). Between 33%-66% of participants merited outreach each month, and clinician outreach required a median of 10 minutes per event. RPM was reported to be helpful by 94% of participants. RPM was associated with a GMI change of -0.25% (P=0.047) for the entire cohort, and stratified analysis revealed greatest treatment effects among participants with baseline GMI of 8.0-9.4% (GMI change of -0.68%, P=0.047; 19.84% reduction in time spent >250 mg/dl, P=0.005). Conclusions: This study demonstrates the feasibility of RPM for patients with T1D using a commercially available population health platform, and suggests that RPM with clinician-initiated outreach may be particularly beneficial for patients with suboptimal glycemic control at entry. However, larger randomized studies are needed to fully explore the glycemic impact of RPM. Clinical trial registration: https://clinicaltrials.gov/ct2/show/NCT04696640, identifier NCT04696640.
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Most participants in that study found the intervention helpful, preferring EMR messages over phone calls and favoring insulin dose guidance over other support.
“Most found the intervention helpful, preferring EMR messages over phone calls and favoring insulin dose guidance over other support.”
From Caregiver experiences of an integrative patient-centered digital health application for pediatric type 1 diabetes care: Findings from a pilot clinical trial (2025) · cites this paper as [52]
That study reported a -0.25% difference in the glucose measurement index between the remote monitoring and control group.
“The study also reported a -0.25% difference in the glucose measurement index, a CGM-based proxy for glucose control, between the remote monitoring and control group [52].”
From Caregiver experiences of an integrative patient-centered digital health application for pediatric type 1 diabetes care: Findings from a pilot clinical trial (2025) · cites this paper as [52]
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- Authors
- Crossen, S. S., Romero, C. C., Lewis, C., & Glaser, N. S.
- Affiliations
- University of California Davis Medical Center (US)
- University of California, Davis (US)
- Corresponding author
- Crossen, Stephanie S.
- Venue
- Frontiers in Endocrinology
- Publisher
- Frontiers Media SA
- Published
- 2023-02-02
- Volume
- 14
- Pages
- 1063290-1063290
- ISSN
- 1664-2392 (ISSN-L)
- PMC
- PMC9931729
- OpenAlex
- W4319040736
- Cited by
- 22
- References
- 18
- Citations by year
- 2026: 6 · 2025: 10 · 2024: 6
- FWCI
- 4.51
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Endocrinology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (K23DK125671)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- remote patient monitoring, type 1 diabetes, continuous glucose monitoring, youth with diabetes, glycemic control, glucose management indicator, hyperglycemia, hypoglycemia, feasibility, remote data sharing, precision medicine, health equity
- MeSH terms
- Glycemic Control, Adolescent, Blood Glucose, Diabetes Mellitus, Type 1, Humans, Surveys and Questionnaires, Blood Glucose Self-Monitoring
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