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

J Clin Endocrinol Metab. 2022 Aug 11:dgac476. doi: 10.1210/clinem/dgac476. Online ahead of print.

ABSTRACT

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 ages 1-17 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 pre-pandemic (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 HbA1c 8.0±1.0% (64±10.9mmol/mol). Diabetes visit frequency increased from 3.8±1.7 visits/pre-pandemic 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) pre-pandemic 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) while 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.

PMID:35948357 | DOI:10.1210/clinem/dgac476