期刊
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
卷 107, 期 10, 页码 E4197-E4202出版社
ENDOCRINE SOC
DOI: 10.1210/clinem/dgac476
关键词
pediatric T1D; COVID-19; CGM; diabetes technology
资金
- National Institute of Diabetes and Digestive and Kidney Diseases [P30DK036836, K12DK094721]
- National Institutes of Health
- Katherine Adler Astrove Youth Education Fund
- Maria Griffin Drury Pediatric Fund
- Eleanor Chesterman Beatson Fund
This study assessed the utility of telemedicine for youth with type 1 diabetes during the COVID-19 pandemic. The results showed that telemedicine led to an increase in visit frequency and improved glucose monitoring indicators.
Purpose The COVID-19 pandemic led to rapid adoption of telemedicine for the care of youth with type 1 diabetes (T1D). We assessed the utility of a primarily virtual care model by comparing glucometrics from a pediatric sample with T1D using continuous glucose monitoring (CGM) both before and during the pandemic. Methods Pediatric patients aged 1 to 17 years with T1D duration >= 1 year if >= 6 years old or >= 6 months if < 6 years old, with >= 1 visit with recorded CGM data both prepandemic (April 1, 2019-March 15, 2020) and during the pandemic (April 1, 2020-March 15, 2021) were included. Data were extracted from the electronic health record. Results Our sample comprised 555 young people (46% male, 87% White, 79% pump-treated), mean age 12.3 +/- 3.4 years, T1D duration 5.9 +/- 3.5 years, baseline glycated hemoglobin A1c 8.0 +/- 1.0% (64 +/- 10.9 mmol/mol). Diabetes visit frequency increased from 3.8 +/- 1.7 visits/prepandemic period to 4.3 +/- 2.2 visits/pandemic period (P < 0.001); during pandemic period, 92% of visits were virtual. Glucose management indicator (GMI) improved slightly from 7.9% (63 mmol/mol) prepandemic to 7.8% (62 mmol/mol) during the pandemic (P < 0.001). Those with equal or greater visit frequency (n = 437 [79% of sample]) had significant improvement in GMI (8.0% to 7.8% [64 to 62 mmol/mol], P < 0.001), whereas those with lower visit frequency did not (7.8 [62 mmol/mol], P = 0.86). Conclusions Children and adolescents with T1D using CGM before and during the pandemic showed an overall increase in visit frequency using primarily telemedicine-based care and improved CGM glucometrics. Further research is needed to understand factors associated with successful use of telemedicine for pediatric T1D.
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