What to Know About Telehealth for Type 2 Diabetes

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Telehealth for type 2 diabetes may have always been useful for many patients, but it became more available—and a necessity—with the arrival of the COVID-19 pandemic. Stay-at-home orders to prevent transmission mean missed appointments unless they can be done virtually. Social distancing means more limited in-person appointment times.

Beyond that, people with type 2 diabetes are more likely to become severely ill and get more serious complications from COVID-19 if they are infected, making reducing possible exposure a top priority.

Type 2 diabetes is a chronic condition that requires ongoing care, and telehealth allows people with this condition and access to technology to keep their diabetes in check from the safety of their own home.

a woman taking a photo of her breakfast and blood sugar monitor

BakiBG / Getty Images

When to Use Telehealth for Type 2 Diabetes

Regular Appointments

Telehealth is a great way for people with type 2 diabetes to have regular checkups with their doctors.

Virtual visits allow healthcare providers to regularly monitor a patient’s blood pressure, blood sugar level, and weight, as well as ask whether they have been following their treatment plan, which may include a weight loss plan and prescription medications.

You may also be able to complete your HbA1C test through telemedicine with dried blood spot testing.

New Symptoms

If you are experiencing new symptoms or side effects from your medications, schedule a virtual visit with your doctor. They can adjust your medication dosage or change your treatment plan through telehealth, and send any new drugs you are prescribed to your local pharmacy for pickup.

However, if your blood glucose remains above 240 mg/dL even after taking your medicine, or you have symptoms that may indicate that you have ketoacidosis (such as fruity breath or trouble breathing), make an appointment to see your doctor in person.

Foot Exam

You can complete your foot exam with your doctor via telehealth by using the camera on your phone, tablet, or computer. Your doctor will be able to examine your feet for any problems like ulcers and let you know whether you need to go into their office for further evaluation and treatment.

Be sure to call your healthcare provider to schedule a visit right away if you have signs of a serious infection, including:

  • A blister, cut, or other foot injury that doesn’t start to heal after a few days
  • A foot injury that feels warm when you touch it
  • Redness around a foot injury
  • A callus with dried blood inside it
  • An injury that is black and smelly, which is a sign of gangrene, or tissue death—a serious complication

You May Need to Be Seen In Person If...

  • You notice your skin, especially that on your foot, has open sores
  • You need a physical exam
  • You need bloodwork or imaging done
  • You have difficulty managing diabetes at home
  • You experience sudden fatigue and blurred vision
  • You have signs of a serious infection

Benefits

Besides keeping people with type 2 diabetes safe during the pandemic, evidence has shown that telemedicine can also enhance treatment compliance and success for those living with this condition.

A meta-analysis that reviewed 43 randomized, controlled trials found that telemedicine interventions led to a significant decrease in HbA1C levels in those with type 2 diabetes.

A small study of 212 patients with the condition found that more than 80% of people using telemedicine interventions adhered to glucose monitoring two to three days per week by the end of the study.

There are various other benefits of telehealth in diabetes care. It ensures:

  • Constant checkups for those who have compromised mobility and can’t travel far for a doctor’s appointment
  • Attention to people with psychological issues like depression
  • Close monitoring of blood sugar levels and the overall treatment plan
  • Health support for patients living in rural areas who can’t visit their doctor regularly
  • Protection from acquiring additional infections when visiting the clinic
  • Time and money savings from not having to commute to an appointment

Limitations

Telehealth is not a substitute for an in-person visit with your doctor in every situation. With telehealth, you may experience some challenges that may prompt you to schedule an in-person visit.

These may include:

  • Lack of access to a stable Internet connection and/or devices needed for telehealth visits like smartphones, tablets, and computers with speakers, a video camera, and a microphone
  • Difficulty navigating the software used to conduct telehealth appointments
  • Lack of complete health insurance for telehealth services, which may lead to more expenses

And as widespread as telehealth is nowadays, some practitioners may simply not offer this option.

How to Prepare for a Telehealth Visit for Type 2 Diabetes

Before your remote visit with your healthcare professional, it is crucial that you prepare.

One of the most important things to do is ensure that whatever device you are using works with the telehealth software your provider uses. The office should provide you with that information when you set up your appointment.

Many systems have an option that allows you to test your system ahead of time to make sure the technology is working for you before your appointment. You may, for example, need to update your browser in order for the software to work, and these running one of these checks can tell you that.

Some require you to set-up an account or download an app. If so, it's best to do this ahead of time as well.

Other things you can do to prepare for your next telehealth visit include:

  • Make a list of questions you want to ask your doctor.
  • Take readings of your blood pressure and send them to your doctor.
  • Make note of any prescriptions that need to be refilled.
  • Wear clothes that will allow you to show your doctor parts of your body, if needed.
  • Keep track of your weight and other vital signs, as you may need to share them with your doctor during the virtual meeting.
  • Choose a bright space with good Internet connection and free from distractions so that there aren’t any visual problems or interruptions during the meeting.
  • If you have insurance, contact your provider to confirm their coverage of telehealth visits.
  • Reach out to your doctor’s office with any further questions you may have regarding the appointment.

Does Medicare Cover Telehealth for Diabetes?

Starting in 2020, Medicare made some changes to telehealth coverage, which include support of virtual check-ins and telehealth visits for those enrolled in Medicare Part B. However, not all services are covered. Ask your provider's billing department whether or not the service you are seeking is eligible. You can also learn more at Medicare.gov.

What Happens During the Visit?

During your visit, your doctor may ask you questions about different aspects of your health and diabetes management plan, including:

  • Your diet
  • Your exercise routine
  • Medications you are using
  • Symptoms of any nerve damage or numbness in your limbs
  • Your blood sugar monitoring regimen 
  • How often you experience low or high blood sugar
  • What you currently weigh
  • Your intake of alcohol, if applicable
  • Mental disorders, such as depression

Based on your feedback, your doctor may recommend changes to your diet and medications.

You may not have to conduct future telehealth visits if you can manage your diabetes properly and easily access the clinic in the case of emergencies. Your provider will let you know if and when you need to be seen in person.

A Word From Verywell

Telehealth is a way of seeing your doctor without leaving your home. It has the potential to not only lower your risk of contracting COVID-19, but also improve your adherence to your diabetes management plan and your health.

While it is much more convenient than an in-person visit, it’s important to note that you may still need to see your doctor in their office on some occasions. Telehealth has great benefits, but is not without its challenges and may be difficult for some to access.

If you are interested in seeing your provider via telehealth, ask them if they offer this service and discuss any concerns you may have about doing that.

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  1. MedlinePlus. Diabetic foot exam. Updated March 3, 2021.

  2. De Groot J, Wu D, Flynn D, Robertson D, Grant G, Sun J. Efficacy of telemedicine on glycaemic control in patients with type 2 diabetes: a meta-analysis. World J Diabetes. 2021 Feb 15;12(2):170-197. doi:10.4239/wjd.v12.i2.170

  3. Wang G, Zhang Z, Feng Y, Sun L, Xiao X, Wang G, Gao Y, Wang H, Zhang H, Deng Y, Sun C. Telemedicine in the management of type 2 diabetes mellitus. Am J Med Sci. 2017 Jan;353(1):1-5. doi:10.1016/j.amjms.2016.10.008

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