{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T14:46:26Z","timestamp":1792161986381,"version":"4.4.0"},"reference-count":23,"publisher":"American Diabetes Association","issue":"5","license":[{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"name":"VA Office of Connected Care"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>More than 25% of U.S. veterans have diabetes, and 78% have a BMI \u226525 kg\/m2. Despite access to lifestyle interventions and specialty endocrine care through the Department of Veterans Affairs (VA), many veterans with uncontrolled diabetes and obesity do not achieve sustained glycemic control or weight loss. We developed the Virtual Diabetes Optimization Program (VDOP), a quality improvement initiative targeting veterans with uncontrolled diabetes (glycated hemoglobin A1c [HbA1c] \u22658% [\u226564 mmol\/mol]) with or without obesity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                    <jats:p>VDOP used a multidisciplinary team\u2014including a registered dietitian, occupational therapist, and clinical pharmacist\u2014delivering frequent virtual care under physician diabetologist supervision. Outcomes were compared with veterans who declined VDOP and received standard endocrine care during the same period. Primary outcomes were changes in HbA1c and body weight at 6 and 12 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 39 veterans completed VDOP and 62 received standard care. Baseline characteristics were similar, though VDOP participants had higher BMI. After 6 months, VDOP participants had significantly greater mean reductions in HbA1c compared with those receiving standard care (mean HbA1c decreased from 9.8% [84 mmol\/mol] to 7.1% [54 mmol\/mol] vs. 10.6% [92 mmol\/mol] to 8.2% [66 mmol\/mol]) and greater percent weight loss (\u22126.8% vs. \u22120.7%), with these differences remaining significant at 12 months. Differences remained significant after adjustment for baseline values and diabetes medications, including glucagon-like peptide 1 receptor agonists.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>VDOP was associated with greater improvements in glycemic control and weight loss compared with standard endocrine care. Prospective studies are needed to assess long-term outcomes and cost-effectiveness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/doc26-0020","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T14:15:03Z","timestamp":1788358503000},"page":"902-909","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":0,"title":["Virtual Diabetes Optimization Program (VDOP) for Veterans With Uncontrolled Diabetes"],"prefix":"10.2337","volume":"1","author":[{"given":"Thomas","family":"Adel","sequence":"first","affiliation":[{"name":"Medical College of Wisconsin 1 , Milwaukee, WI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill","family":"Hansen","sequence":"additional","affiliation":[{"name":"Clement Zablocki Veterans Affairs Medical Center 2 , Milwaukee, WI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jillian","family":"Taxman","sequence":"additional","affiliation":[{"name":"Clement Zablocki Veterans Affairs Medical Center 2 , Milwaukee, WI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meghann","family":"Reetz-Norton","sequence":"additional","affiliation":[{"name":"Clement Zablocki Veterans Affairs Medical Center 2 , Milwaukee, WI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Johnson","sequence":"additional","affiliation":[{"name":"Clement Zablocki Veterans Affairs Medical Center 2 , Milwaukee, WI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikola","family":"Ljubic","sequence":"additional","affiliation":[{"name":"Clement Zablocki Veterans Affairs Medical Center 2 , Milwaukee, WI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Garrett","family":"Ash","sequence":"additional","affiliation":[{"name":"VA Connecticut Healthcare System, Center for Pain, Research, Informatics, Medical Comorbidities and Education Center 3 , West Haven, CT"},{"name":"Yale School of Medicine, General Internal Medicine 4 , New Haven, CT"},{"name":"Yale School of Medicine, Department of Biomedical Informatics and Data Science 5 , New Haven, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeff","family":"Whittle","sequence":"additional","affiliation":[{"name":"Medical College of Wisconsin 1 , Milwaukee, WI"},{"name":"Clement Zablocki Veterans Affairs Medical Center 2 , Milwaukee, WI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1875-6124","authenticated-orcid":false,"given":"Carlos E.","family":"Mendez","sequence":"additional","affiliation":[{"name":"Medical College of Wisconsin 1 , Milwaukee, WI"},{"name":"Clement Zablocki Veterans Affairs Medical Center 2 , Milwaukee, WI"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2026,9,2]]},"reference":[{"key":"2026101610020144800_B1","unstructured":"Centers for Disease Control and Prevention (CDC)\n          . 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Accessed 23 September 2024. Available from https:\/\/www.cdc.gov\/obesity\/php\/about\/index.html"},{"key":"2026101610020144800_B6","doi-asserted-by":"crossref","first-page":"751","DOI":"10.2337\/dc19-0573","article-title":"The association between poor glycemic control and health care costs in people with diabetes: a population-based study","volume":"43","author":"Mata-Cases","year":"2020","journal-title":"Diabetes Care"},{"key":"2026101610020144800_B7","doi-asserted-by":"crossref","first-page":"1524","DOI":"10.2337\/dc20-3045","article-title":"American Diabetes Association framework for glycemic control in older adults: implications for risk of hospitalization and mortality","volume":"44","author":"Rooney","year":"2021","journal-title":"Diabetes Care"},{"key":"2026101610020144800_B8","first-page":"A98","article-title":"Design and dissemination of the MOVE! weight-management program for veterans","volume":"6","author":"Kinsinger","year":"2009","journal-title":"Prev Chronic Dis"},{"key":"2026101610020144800_B9","doi-asserted-by":"crossref","first-page":"348","DOI":"10.3389\/fendo.2019.00348","article-title":"Long-term effects of a novel continuous remote care intervention including nutritional ketosis for the management of type 2 diabetes: a 2-year non-randomized clinical trial","volume":"10","author":"Athinarayanan","year":"2019","journal-title":"Front Endocrinol"},{"key":"2026101610020144800_B10","doi-asserted-by":"crossref","first-page":"3961730","DOI":"10.1155\/2018\/3961730","article-title":"Remote lifestyle coaching plus a connected glucose meter with certified diabetes educator support improves glucose and weight loss for people with type 2 diabetes","volume":"2018","author":"Bollyky","year":"2018","journal-title":"J Diabetes Res"},{"key":"2026101610020144800_B11","doi-asserted-by":"crossref","first-page":"S14","DOI":"10.2337\/dc25-S001","article-title":"1. Improving care and promoting health in populations: Standards of Care in Diabetes\u20142025","volume":"48","author":"American Diabetes Association Professional Practice Committee","year":"2024","journal-title":"Diabetes Care"},{"key":"2026101610020144800_B12","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1016\/j.eprac.2022.08.002","article-title":"American Association of Clinical Endocrinology clinical practice guideline: developing a diabetes mellitus comprehensive care plan\u20142022 update","volume":"28","author":"Blonde","year":"2022","journal-title":"Endocr Pract"},{"key":"2026101610020144800_B13","unstructured":"VA Telehealth Services celebrates 20 years\n          . VA News, 2023. Accessed 18 November 2024. Available from https:\/\/news.va.gov\/118570\/va-telehealth-services-celebrates-20-years\/"},{"key":"2026101610020144800_B14","unstructured":"U.S. Department of Veterans Affairs\n          . VHA 2023 annual report shines spotlight on Connected Care. 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