The current study investigated the feasibility of telehealth-delivered diabetes self-management education and support (DSMES) for older adults with type 2 diabetes mellitus following hospital discharge. The intervention included one in-person home visit and follow-up weekly virtual DSMES for 4 additional weeks. Diabetes knowledge was measured at baseline and completion of the program. The Telehealth Usability Questionnaire was completed following the final session. Hemoglobin A1C (A1C) level was abstracted from the electronic health record at baseline and 3 months post hospital discharge. Hospital re-admissions were measured at 30 days post index hospital stay. Of the 20 patients enrolled, 12 completed the intervention. The most common reason for attrition was discharge to a skilled nursing facility (3/20). Participants who completed the intervention increased their diabetes knowledge scores. A1C values decreased by 1.1%, and there were no hospital readmissions for any patient who completed the program. Participants described the program as useful and were satisfied with the program. These results suggest that it is feasible to identify and enroll patients in a telehealth education program for diabetes during hospital admission. [ Research in Gerontological Nursing, 13 (3), 138–145.]

Purpose: Diabetes Self-Management Education (DSME) is a crucial aspect of treating type 2 diabetes mellitus (T2DM). Daily individual decisions affect patient health, well-being, and long term outcomes. This pilot study evaluated what best educates and motivates patients to improve glucose control. Method: 17 participants with T2DM were recruited from Penn Rodebaugh Diabetes Center to attend 3 monthly diabetes support group meetings, and receive American Association of Diabetes Educators education. Weight and hemoglobin A1C (A1C) were measured at baseline and completion. Fitbit Activity Trackers were provided, as well as bi-weekly communication to reinforce behavior change. Pre and post-study surveys assessed nutrition, activity, monitoring blood glucose, and taking medication. Two sided paired t-test was performed to compare change in A1C and weight. A type I error rate of 0.was used for statistical significance. Results: 15 participants completed the study. DSME interventions resulted in a statistically significant decrease in mean A1C from 8.5% to 7.7% with a mean A1C reduction of 0.8% in 3 months (p-value=0.01). Mean weight decreased 4.80 lb (p-value=0.0001). 11 remained on same medications, and 1 required reduced insulin. 3 added a glucagon-like peptide receptor agonist (GLP-1RA), with 1 adding a sodium-glucose cotransporter-2 inhibitor. 7 increased daily steps wearing Fitbit, while 8 reported no motivation. 10 increased weekly exercise, and 11 increased daily activity. All benefited from bi-weekly reinforcement, and reported improved nutrition. Food replica models aided visual reinforcement. Conclusion: DSME in a group setting can motivate self-care and reduce both A1C and weight, however, the study met challenges. Time per patient spent coordinating was substantial. Food models and phone communication to reinforce lifestyle modification were useful. Research is needed to determine what provides long-term sustainability in a busy clinical practice. Disclosure L. McLeer Maloney: None. J. Flood: None. N. Alamuddin: Consultant; Self; Novo Nordisk Inc.. M. Al Mukaddam: None.

Compared to older adults without type 2 diabetes (T2D) older adults with T2D have higher rates of hospital admission and readmission. Despite having a diagnosis of T2D, attendance of diabetes self-management education (DSME) classes by older adults is low. Hospitalizations are an opportune time to engage older adults with T2D, currently no interventions exist utilizing telehealth and DSME for this population during transitions. The purpose of this study is to demonstrate the feasibility of providing DSME through telehealth to older patients with T2D following a hospital admission. We conducted a qualitative study using semi-structured, face-to-face interviews with older adults with T2D engaged in a post-discharge DSME telehealth transitions intervention. Hospitalized older adults (≥ 55 years of age) with T2D were recruited. An advanced practice nurse certified diabetes educator provided one in-person home visit within 48 hours of discharge and weekly DSME sessions via electronic tablet for four additional weeks. After completion of the program, eight patients were asked to describe their experience using the tablet to receive DSME, describe any behavior changes, and if they would accept future education virtual visits. Interviews were audio-recorded, transcribed verbatim and content analyzed thematically. Participants (50% male, aged 57-73 years, 75% African American), cited inconvenience and lack of availability as the leading cause for prior DSME non-attendance. Participants described an increased awareness of dietary habits and more frequent monitoring of glucose. Seven out of 8 participants indicated they would participate in future virtual DSME sessions. Every participant indicated the technology was easy to use and would recommend sessions to others. Our findings support ADA recommendations to improve transitions and to evaluate DSME need at this critical time. Technology use is feasible to enhance availability and convenience for continued DSME in the home after a hospital admission. Disclosure C.R. Whitehouse: None. J.A. Long: None. L. McLeer Maloney: None. D.A. Horowitz: None. K. Bowles: None.