What to Know About Telehealth for Type 2 Diabetes - Verywell Health

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Telehealth for type 2 diabetes has become a necessity during the COVID-19 pandemic when social distancing and stay-at-home orders have been implemented to prevent transmission of the novel coronavirus.

These precautions are especially important for people with type 2 diabetes to follow because their conditions make them more likely to become severely ill and get more serious complications from COVID-19 if they are infected. That covers a large proportion of the population: About one in 10 Americans have diabetes, and 90% to 95% of them have type 2 diabetes.

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

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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 doctor. Virtual visits allow healthcare providers to regularly monitor a patient’s blood pressure, blood sugar level, and weight, as well as to 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

Using the camera on your phone, tablet, or computer, you can complete your foot exam with your doctor via telehealth. 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.

However, you should 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, the death of body tissue and 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 and Challenges

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 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 of Telehealth for Type 2 Diabetes

However, telehealth is not a substitute for an in-person visit with your doctor in every situation. With telehealth, you may experience some challenges which may prompt you to schedule an in-person visit. These may include:

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

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 and get yourself ready. One of the most important things to do is to ensure you are using the same technology your doctor or nurse will be using to reach you. You may want to set things up before the meeting so you become familiar with the technology.

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 loose, presentable clothes so you can show your doctor parts of your body if needed.
• Reach out to your doctor’s office with any further questions you may have regarding the appointment.
• 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.
• Contact your insurance provider to confirm their coverage of telehealth visits.

Will Insurance Cover Telehealth for Diabetes?

Starting in 2020, Medicare made some changes to telehealth coverage, which includes support of virtual check-ins and telehealth visits for those enrolled in Medicare Part B. However, not all services delivered via audio devices are covered. Check with the billing department of your doctor’s office and your insurance company to ensure that your telehealth services will be covered.

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:

• The diet you have been maintaining and your exercise routine
• Medications you are using
• Symptoms of any nerve damage or numbness in your limbs
• Your blood sugar monitoring regime 
• How often you experience low blood sugar 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. And telehealth is not without its challenges and may be difficult to access for some.

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

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