More than medications alone, managing diabetes means mastering habits that affect day-to-day living: how to eat, how often to exercise, and how to monitor blood sugar and other markers of health. Yet under routine care, many patients with diabetes see their doctors a few times a year for just minutes. Now a team led by Arshiya Baig, Associate Professor of Medicine and Associate Director of Chicago Center for Diabetes Translation Research at the University of Chicago and co-director of C3EN’s Investigator Development Core, is testing how structured virtual diabetes group education visits can improve the success of patients as they learn to manage their disease.
Affecting over 38 million Americans, diabetes is a chronic condition that results in elevated blood sugar levels and an increased risk for heart disease, stroke, kidney disease, vision loss, and amputation. Ninety to 95% of patients have the Type 2 form of the disease, which is typically acquired in middle age and older adults–often after lifestyle habits have become entrenched. Diabetes risk is higher in populations with lower levels of income and education. The challenges of receiving diabetes education, particularly within these populations, have made it difficult for many individuals to access the care they need.
Virtual Diabetes Group Visits Across Health Systems (VIDA) is a six-month curriculum in monthly sessions delivered online to small groups of patients. A virtual format and social support structure showed promise in improving the health and well-being of individuals with diabetes during a pilot study conducted during the pandemic. VIDA is in the midst of a randomized control trial in partnership with Access Community Health Network (ACCESS), one of the nation’s large federally qualified health centers serving over 150,000 low-income patients, and Advocate Health, a private not-for-profit health system with over 117,000 patients. This project is one of several studies supported by the Chicago Chronic Condition Equity Network (C3EN), a collaboration between the University of Chicago and Rush University to eliminate health disparities related to chronic diseases in the Chicago area.
The idea for VIDA came after Baig had already spent many years working with health centers across the Midwest. “We had started a project on shared medical visits— not just group education, but where people receive support, education, and also have vitals checked, lab work done, immunizations, and a focused clinical appointment with the provider. During COVID, we couldn’t bring groups together in person, especially people living with type 2 diabetes. So we switched to virtual, and it was actually fairly successful,” she says. Noting that having doctors attend the visits virtually would likely not be feasible or sustainable, they decided to explore diabetes education groups that could maintain a strong linkage to primary care. “After each visit, the diabetes educator would write a progress note and route it to the primary care doctor, making sure patients are getting their A1C checked and completing necessary care lab work. This way, primary care providers stay in the loop and are aware of what patient is learning, their goals, and progress.”
Developed in partnership with ACCESS, Advocate, and the Midwest Clinicians Network, the current curriculum combines basic diabetes education with specific sessions on nutrition, physical activity, and other topics. Each 90-minute session is led by a diabetes educator, and groups are capped at five to seven patients each to facilitate discussion and connection among the participants.
The curriculum also encourages participants to set SMART goals–specific, measurable, achievable, realistic, and time-bound goals, such as losing 5 pounds in two months. “We encourage participants to set attainable goals, track their progress, and build on them,” says Chasity Kasir, a research assistant on the project. “Social support plays a big role in the study. Participants can share tips with each other, such as ways to fit more physical activity into their busy schedules. This peer support is valuable, and we saw its impact during the pilot. We’re excited to see how it plays out in the randomized control trial.”
So far VIDA has recruited about 100 patients to the study. The first cohort of patients completed the curriculum in December and January, and the last is expected to finish in Fall 2025. To measure the impact of the group visits, researchers track patients’ A1C, a measure of their average blood sugar level over the past three months, for a year after enrolling in the program.
“Patients have consistently shared during the group visits how invaluable the virtual aspect is. They join while making dinner or managing their caregiving duties and really appreciate the flexibility of the format,” says Abigail Durgan, VIDA project manager, who notes that the prevalence of virtual meetings during the pandemic has allowed the technology to be widely adopted in all communities. “Patients have really appreciated the social support and educational opportunities that VIDA has provided to them, and the literature shows that so much of having controlled diabetes is related to this emotional burden of managing it.”
“Our project is really a testament to designing initiatives in partnership with health systems and leadership to integrate them into workflows and consider sustainability,” says Baig. “Not many interventions have been implemented in both FQHCs and large hospital systems, but we’ve been able to integrate our approach with these two health systems. I hope we’ll demonstrate that this program is a valuable resource for adults with diabetes across Chicagoland. If it helps people engage more in their care, feel empowered, and receive more social support, I think it could be a valuable intervention. After we see results, scalability and sustainability will be the next step.”