Use of telemedicine to improve glycemic management in correctional institutions

Telemedicine was used to provide diabetes consultations to improve glycemic control for individuals incarcerated in 12 institutions in the New York State penal system. A total of 108 televisits were conducted from January 1, 2004 to February 28, 2007, with 43 males with multiple medical comorbidities and difficult-to-control type 1 (35%) or type 2 (65%) diabetes. Most (86%) required insulin therapy. It was found that the number of individuals with poorest glycemic control (hemoglobin A1c >9%) was reduced by approximately 40%, and 29% of the patients were able to achieve a hemoglobin A1c <7%. The greatest improvements in glycemic control were observed in those with frequent televisits over a longer duration of follow-up. This suggests that telemedicine is a feasible approach for improving diabetes care in this population.