A randomized trial comparing supplemental video care and asynchronous remote monitoring among young people with type 1 diabetes and elevated glycemic levels
In brief
Monthly video care trended toward 1-point lower HbA1c in young people with type 1 diabetes
In a 6-month trial of 65 young people with elevated blood sugar, monthly video visits were associated with HbA1c about 1 percentage point lower than usual care, but the difference did not meet the threshold for statistical significance. Remote monitoring showed no significant difference, and high dropout in both groups leaves open whether video care can reliably improve blood sugar.
- Journal
- Pediatric diabetes (Q1)
- Published
- 26 August 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Stephanie Crossen, Salvador Lopez, Carrie Lewis, Daniel Tancredi, Amy Hughes-Lansing, Nicole Glaser
- PMID
- 42812206
- DOI
- 10.48130/pedi-0026-0007
Why clinicians should know about it
- Picked for Health Informatics (paper of the day, 1 October 2026): RCT comparing video visits vs RPM for T1D
- Picked for Family Practice (paper of the day, 1 October 2026): Video visits longer, cover behavior, emotional support, trend lower HbA1c
Abstract
Telehealth can enable supplemental care to young people with type 1 diabetes (T1D) in need of frequent guidance or treatment changes. However, the relative benefits of different telehealth modalities (e.g., synchronous video visits versus asynchronous remote patient monitoring [RPM]) for specific populations remain unclear. We conducted a three-arm randomized controlled trial comparing supplemental monthly video visits or monthly RPM versus usual care over 6 months among young people aged 5-18 years with established T1D and hemoglobin A1c (HbA1c) > 8%. The study cohort of 65 participants was 57% publicly insured, with 54% White and 26% Hispanic/Latino, a mean age of 13.4 years, a T1D duration of 5.8 years, a baseline HbA1c of 9.7%, and high baseline use of continuous glucose monitoring (98%) and insulin pumps (77%). Both study arms experienced high rates of attrition (45% among video participants, 35% among RPM participants). Compared with RPM encounters, video visits were longer (mean: 29.8 vs 17.2 min, p < 0.001) and more likely to cover topics beyond insulin dose adjustments, such as diabetes behaviors, technology use, and emotional support. Intention-to-treat analysis demonstrated a trend (p = 0.06) toward 1.0% lower mean HbA1c at study completion among video participants compared with usual care, adjusting for baseline factors; no significant difference was seen for RPM. Feedback about both interventions was highly positive. These findings suggest that among young people with elevated HbA1c despite using diabetes technology, supplemental synchronous, individualized interactions may be more effective at reducing HbA1c than supplemental data review with asynchronous outreach.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.