Efficacy of the Telemedicine for Reach, Education, Access, and Treatment (TREAT) model for diabetes care.

Videoconferencing-based telemedicine services have the potential to address the problem of poor access to diabetes specialists in remote rural communities. However, evidence of efficacy of telemedicine services on HbA1c in the rural setting has been quite limited. We created the Telemedicine for Reach, Education, Access, and Treatment (TREAT) modelda system that combines videoconferencing consultations provided by an endocrinologist at an urban center in collaboration with a local diabetes educator. In this study, we tested the efficacy of TREAT on HbA1c control. Protocols were approved by the local institutional review board. Volunteers with type 2 diabetes with HbA1c .7.0% and residing within a medically underserved rural Pennsylvania community were recruited. Referral, recruitment, and telemedicine consultations between urban and rural sites were conducted as in one of our previous studies (1). Seventy-one patients were referred, of which 40 expressed an interest in participating. Thirty-one patients consented and enrolled; two withdrew and four were lost to follow-up between the first and second follow-up assessment. At each telemedicine visit at the rural site, participants were assisted by the local diabetes nurse educator. Each participant underwent a telemedicine visit with an urban center–based endocrinologist at baseline and3months later for adjustments Table 1—Characteristics of participants at baseline