Metabolic, self-care and mental health characteristics of patients with type 2 diabetes in a hybrid (face-to-face and virtual) comprehensive care program.

Abstract

Background and aims: During the COVID-19 pandemic confinement, virtual care strategies were implemented for individuals with type 2 diabetes (T2D). During the recovery process, hybrid care schemes (combining in-person and virtual care) continued, with limited information available on the results. This study aims to describe the metabolic parameters, lifestyle, self-care behaviors, and mental health of patients treated in the hybrid comprehensive care program.

Methods: This is a descriptive and longitudinal observational study in patients with T2D who attended the hybrid comprehensive care program, comprising baseline (face-to-face), 3-month follow-up (face-to-face), 1-year follow-up (virtual), and 2-year follow-up (face-to-face). Metabolic and mental health variables were obtained (presence of anxiety, affective and eating disorders, quality of life questionnaires, Hospital Anxiety and Depression Scale for depression and anxiety, problem areas in diabetes, and empowerment) as well as self-care variables: calories consumed, exercise time, self-monitoring blood glucose, and foot checks.

Results: Data from 104 patients were analyzed from October 2018 to November 2022, with a mean age of 55 (48-61) years, a female predominance of 49%, and a time since diagnosis of T2D of 2 (0-3) years. Metabolic parameters improved at 3 months, 1 year, and 2 years of follow-up. In self-care behaviors, the differences in minutes per week of exercise increased (baseline: 0 (0-180), 3 months: 175 (60-330), 1 year: 0 (0-150), and at 2 years: 90 (0-195); p < 0.0001). In self-care activities, we observed an increase in the proportion of patients who checked their feet and performed glucose self-monitoring (p < 0.001). A good quality of life, without distress and empowerment, has also improved.

Conclusion: During a comprehensive care hybrid program, patients could maintain metabolic control goals, engage in self-care behaviors, mainly foot care and glucose self-monitoring, and improve their mental health parameters.