David Panzirer, trustee of The Leona M. and Harry B. Helmsley Charitable Trust, authored a paper in Diabetes Technology and Therapeutics that, convincingly, shows how the standard-of-care can improve for the type 1 diabetes (T1D) community: telemedicine.

As Mr. Panzirer explains in the paper published in May 2020, geography is a key determinant in the care people with T1D get. There is a significant shortage of endocrinologists in the United States, including in metropolitan areas. This has, unfortunately, led to many people with T1D relying upon their Primary Care Physicians (PCP) to treat their T1D. Mr. Panzirer argues that PCPs do not have the time or the reimbursement model needed to learn how to properly treat people with T1D. Simply put: many people with diabetes do not receive the expert care required to improve their blood sugar control or adopt the latest technology, which includes continuous glucose monitors (CGM)—a game-changing technology for monitoring blood sugar.

But what if geography wasn’t a barrier anymore? That’s exactly what Mr. Panzirer and The Helmsley Charitable Trust have in mind.

The Helmsley Charitable Trust, along with the Jaeb Center for Health Research and Cecelia Health, devised a pilot study where 35 people who lived in rural settings, saw a PCP for their diabetes care, used basal/bolus insulin regimens and were unfamiliar with CGM technology received care through a Virtual Specialty Clinic. The results were impressive. Participants saw a decrease in HbA1c, an increase in time-in-range and experienced improved psychosocial outcomes. All participants decided to keep using CGM technology after the study ended. There are plans for a followup study with 300 participants.

In addition to advocating for a widespread network of telemedicine for people with T1D, Mr. Panzirer also highlights the inefficient system of data collection employed by each CGM manufacturer. At the moment, there is no standard way to collect data from CGMs. This is unlike, for example, electrocardiograms (EKGs), which have a single report universal across different EKG machine manufacturers. Providers need better, easier access to patient data, and a standardized data report would help significantly.  

Access to better health care will improve outcomes for people with T1D. Mr. Panzirer and The Helmsley Charitable Trust have outlined a way to make that happen. 

Read the paper here.