Electronic Consults (EC) offer enhanced access to endocrinologists for patients with type 2 diabetes mellitus (T2DM). The effects of EC on costs of care and glycemic control compared to Face-to-Face (F2F) visits are unknown. A retrospective chart review was conducted for Veterans who received EC (n=440) or F2F (n=397) care for T2DM through the VA Pittsburgh Healthcare System (VAPHS) from 2010 to 2015. Data on demographics, rurality, days to consult completion, and percent (%) A1C at baseline and post-consult at 3-6, and 12 months were collected. A web-based tool calculated the average round-trip distance in miles and travel time in hours from patient’s residential zip code to VAPHS. Annual travel costs for recommended 3 visits per year were estimated at a reimbursement rate of $0.415 per mile. Continuous measures (mean ± standard deviation) were compared using Wilcoxon rank-sum tests. Categorical measures (sex, rurality) were presented as percentages and compared between groups by time point using chi-square tests. Veterans who received EC were predominantly male (98.4%), younger (64.2±8.5 years) and rural (15.8%) than those who received F2F care (95.3% male, p=0.01; 68.1±8.7 years, p<0.0001; 3.7% rural, p<0.0001). The EC cohort had shorter consult completion time than the F2F cohort (EC: 10±10 days, F2F: 37±33; p<0.0001). Mean annual travel-related savings per Veteran in the EC cohort were 431±297 miles, 9.4±7 hours, and $179±123. Mean annual travel burden per Veteran in the F2F cohort were 159±171 miles, 3.5±4 hours and $66±71. EC and F2F cohorts had similar baseline A1C values (10%±1.6). Both cohorts had decline in baseline percent A1C to 3- 6 months (EC: 8.98%±1.54, F2F: 8.75%±1.77, p=0.03) and from baseline percent A1C to 12 months (EC: 8.80%±1.61, F2F: 8.57%±1.72, p=0.002). Electronic consults deliver effective and expedient care by saving money and travel time, and offer long-term, sustainable glycemic control comparable to F2F care for patients in remote areas with T2DM. Disclosure N. Karajgikar: None. K.B. Detoya: None. J.N. Beattie: None. S.J. Lutz-McCain: None. M.Y. Boudreaux-Kelly: None. A. Bandi: None.

Background: The OPTIFAST® program at UPMC is a medically supervised program using very low calorie diet from Nestle products. It focuses on nutrition and lifestyle counseling, and transitioning to a low glycemic load diet to sustain glycemic benefits of weight loss. We evaluated the impact of our program on weight reduction in a 3-year period at UPMC clinics, and secondary parameters defining cardiovascular risk factors. Methods: Patients were divided into Completer (C) and Non-Completer (NC) cohorts. For the C-group, HBA1C for diabetics, lipid profiles and systolic blood pressure (SBP) were compared at baseline and at >5 months. Adjusting for weight loss, effect of DM, BP and lipid-lowering drugs on HBA1C, SBP and lipid profile, respectively, was also evaluated. Results: A total of 215 patients (mean age=49.63, 69% female) had mean baseline and end weights of 263.7 and 222.8 pounds respectively, with mean 14.04% weight loss (p<0.0001). 59% completed the program with mean 19.52% weight loss (p<0.0001). For the NC-group, weight difference from baseline was not significant. Among diabetics, there was decrease in HBA1C (7.8% to 6%, p<0.0001), with a decrease in the no. of insulin units/day (71.4 to 34.6 units, p=0.015), but no significant decrease in the no. of noninsulin drugs from baseline to >5 months. There was a decrease in mean baseline to end SBP (139.3 to 122.5 mmHg, p=0.0325), and no. of BP meds (1.9 to 1.2, p<0.0001). There was a decrease in mean baseline to end values of: total cholesterol (TC) (192.4 to 140.7 mg/dl, p<0.0001), LDL (104.3 to 84.59 mg/dl, p=0.02) and triglycerides (TG) (209.2 to 111.9 mg/dl, p<0.0001). The increase in baseline to end HDL and difference in lipid lowering drugs were not significant. Adjusting for weight loss, medications had no significant association on trends of HBA1C, SBP and lipid profile. Conclusions: Among completers, the medically supervised VLCD program at UPMC promotes significant weight loss, glycemic and SBP improvement, and lowering of TC, LDL and TG for over >5 months. Disclosure K.B. Detoya: None. K. Han: None. B.R. Register: None. D.A. Rometo: None.