Improved CGM Glucometrics and More Visits for Pediatric Type 1 Diabetes Using Telemedicine During 1 Year of COVID-19

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.

Automated summary

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.