TOPLINE:

A nurse practitioner (NP)-led remote patient monitoring (RPM) program for uninsured patients with diabetes achieved a mean reduction of 3.3 percentage points in A1c levels, with the sharpest decline observed in the first 3 months, according to a study.

METHODOLOGY:An NP-led clinic providing free diabetes care was formed at an urban hospital as a part of an RPM program that enrolled 45 uninsured patients with diabetes (47% female; 64% Black; 29% White; 7% Hispanic) from July 2021 to February 2023.Participants received a glucometer, test strips, lancets, and a modem; hospital staff monitored blood glucose levels transmitted by participants on weekdays; NPs reviewed weekly charts and called those with out-of-range values (> 350 mg/dL or < 70 mg/dL in more than two consecutive readings) to discuss strategies for management. Remote monitoring was discontinued when patients reached target A1c levels of less than 7%.The outcomes included the mean change in A1c levels before and after participation in the RPM program.TAKEAWAY:Mean A1c levels decreased from 11.6% to 8.3% (mean difference, 3.3%; 95% CI, 2.5%-4.1%).The greatest decrease in A1c levels occurred within the first 100 days, followed by a plateau from 100 to 200 days and a slight increase thereafter.Overall, RPM was discontinued in 56% of patients after reaching the target A1c levels and in 31% due to nonresponse or a lack of transmissions.IN PRACTICE:

“Overall, the findings of this initiative support the value of continued nursing advocacy and policy initiatives to address the disparities in access to technology and interventions that contribute to poor health outcomes among underserved populations with diabetes,” the authors of the study wrote, concluding that “insights gained through initial stages of implementation of an RPM program indicate that barriers to self-monitoring of BG [blood glucose] can be addressed and that glycemic control in a vulnerable population can improve through remote monitoring and telehealth follow-up by a team of NPs.”

SOURCE:

The study was led by Alison Hernandez, PhD, MPH, RN, School of Nursing, The University of Alabama at Birmingham. It was published online on November 20, 2025, in The Journal for Nurse Practitioners.

LIMITATIONS:

Communication challenges posed significant barriers, with nearly 75% of nonparticipating enrollees being unreachable by telephone. The authors of the study noted that fidelity checks of adherence to the protocol for weekly chart reviews and follow-up calls were not conducted in this quality improvement project. Additionally, the lack of a control group in this project restricted conclusions about its efficacy.

DISCLOSURES:

The study received partial funding from The University of Alabama at Birmingham Hospital and Health System Foundation. The authors of the study declared having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.