Evaluation of telephone and virtual visits for routine pediatric diabetes care during the COVID-19 pandemic

Fung, Alex C. W.; Irvine, Mike; Ayub, Aysha; Ziabakhsh, Shabnam; Amed, Shazhan; Hursh, Brenden E.

doi:10.1016/j.jcte.2020.100238

Cited by 36 publications

(34 citation statements)

References 20 publications

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“…The COVID-19 pandemic has dramatically changed the approach to patients with chronic diseases. Telemedicine services have been strengthened to minimize hospitalizations, outpatient visits, and, consequently, SARS-CoV-2 exposure risk 7.3 ± 0.7 7.1 ± 0.5 0.120 7.1 ± 0.7 7 ± 0.7 0.168 7 ± 0.5 7 ± 0.6 0.107 [13]. Technology has played a crucial role during this pandemic, particularly for children and adolescents who have been able to continue school lessons and maintain socialization with their peers [14].…”

Section: Discussionmentioning

confidence: 99%

Has COVID-19 lockdown improved glycaemic control in pediatric patients with type 1 diabetes? An analysis of continuous glucose monitoring metrics

Lombardo

Salzano

Basile

et al. 2021

Diabetes Research and Clinical Practice

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Aims Our observational study aimed to evaluate the impact of the lockdown period due to 2019 Coronavirus disease pandemic on glycaemic control in a cohort of paediatric patients with type 1 diabetes (T1D). Methods Eighty-five patients with T1D aged 5–18 years using continuous glucose monitoring (CGM) systems were enrolled. Demographic and clinical data, including glucose metrics generated by CGM-specific web-based cloud platforms, were collected in three different periods (pre-lockdown phase, lockdown phase, and post-lockdown phase) of 90 days each and were statistically analysed. Results During the lockdown period, a clear improvement in almost all CGM metrics (time in range, time above range, coefficient of variation, and glucose management indicator) was observed in our study population, regardless of age and insulin type treatment. In the months following lockdown, maintaining satisfactory diabetes outcomes was confirmed only in younger patients (aged 5–9 years) and in those individuals on hybrid closed loop therapy. Conclusions The increasing use of innovative technological devices together with data sharing systems and interaction with multidisciplinary diabetes team through telemedicine allowed paediatric patients with T1D to improve glucose metrics during the lockdown period. However, our findings showed that the achievement of better glycaemic control was transient for most patients.

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Section: Discussionmentioning

confidence: 99%

Has COVID-19 lockdown improved glycaemic control in pediatric patients with type 1 diabetes? An analysis of continuous glucose monitoring metrics

Lombardo

Salzano

Basile

et al. 2021

Diabetes Research and Clinical Practice

View full text Add to dashboard Cite

show abstract

“…Telemedicine and other digital strategies were among the most successful strategies during the pandemic and are seen as permanent [16,45,46,47,49,71]. They allowed continuity of diabetes care in a safe and flexible manner [53,55], reducing no-show rates -4% only in Bahrain [45] -and alleviating part of the pressure by optimizing health systems' resources.…”

Section: Lessons Learned: New Normal and Barriersmentioning

confidence: 99%

COVID-19 associated with diabetes and other noncommunicable diseases led to a global health crisis

Barone

Ngongo

Harnik

et al. 2021

Diabetes Research and Clinical Practice

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COVID-19 has gravely threatened high-risk populations, such as people with diabetes and other noncommunicable diseases, leading to disproportionate hospitalizations, longer and repeated hospital stays and deaths among these individuals worldwide. It is well documented from previous outbreaks that diabetes increases the risk for poor outcomes due to SARS infection. In the present review, we bring evidence that country and global level health crisis caused by COVID-19 could have been avoided or highly minimized if measures to protect high-risk populations were implemented timely. In addition to general lockdowns, testing, tracing, isolation and hygiene measures, other specific interventions for diabetes and comorbidities management were key to allow the continuation of care services during the pandemic. These interventions included: teleconsultation, digital remote education/monitoring, e-prescription/medicine delivery options, mobile clinics, home HbA1c and albumin-creatinine tests. In this article, we recommend prompt actions to protect the most vulnerable groups, valuing knowledge and experiences from previous outbreaks and lessons learned during the COVID-19 pandemic, in order to shield communities, health systems and the global economy.

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“…The pandemic certainly accelerated its broader implementation. Almost all participants agreed with the concept of telemedicine, favoring telephone and video calls as their preferred means of communication also for future care [73,93], the strategy has proved to be valid not only for patients, but also for caregivers and health professionals [62]. The use of platforms such as Zoom, Viber and Facebook, widely used for group and workgroup connections has proved to be an especially useful tool for teenagers and caregivers, both from an educational point of view and for optimizing the use of pumps and other devices, with positive results in the guidance and glycemic control of patients [58,63,64].…”

Section: Discussionmentioning

confidence: 99%

Newest Diabetes-Related Technologies for Pediatric Type 1 Diabetes and Its Impact on Routine Care: a Narrative Synthesis of the Literature

et al. 2021

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Purpose of Review This review aims to address the actual state of the most advanced diabetes devices, as follows: continuous subcutaneous insulin infusions (CSII), continuous glucose monitoring systems (CGM), hybrid-closed loop (HCL) systems, and "Do-it-yourself" Artificial Pancreas Systems (DIYAPS) in children, adolescents, and young adults. This review has also the objective to assess the use of telemedicine for diabetes care across three different areas: education, social media, and daily care. Recent Findings Recent advances in diabetes technology after integration of CSII with CGM have increased the popularity of this treatment modality in pediatric age and shifted the standard diabetes management in many countries. We found an impressive transition from the use of CSII and/or CGM only to integrative devices with automated delivery systems. Although much has changed over the past 5 years, including a pandemic period that precipitated a broader use of telemedicine in diabetes care, some advances in technology may still be an additional burden of care for providers, patients, and caregivers. The extent of a higher rate of "auto-mode" use in diabetes devices while using the HCL/DIYAPS is essential to reduce the burden of diabetes treatment. Summary More studies including higher-risk populations are needed, and efforts should be taken to ensure proper access to cost-effective advanced technology on diabetes care.

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Evaluation of telephone and virtual visits for routine pediatric diabetes care during the COVID-19 pandemic

Cited by 36 publications

References 20 publications

Has COVID-19 lockdown improved glycaemic control in pediatric patients with type 1 diabetes? An analysis of continuous glucose monitoring metrics

Has COVID-19 lockdown improved glycaemic control in pediatric patients with type 1 diabetes? An analysis of continuous glucose monitoring metrics

COVID-19 associated with diabetes and other noncommunicable diseases led to a global health crisis

Newest Diabetes-Related Technologies for Pediatric Type 1 Diabetes and Its Impact on Routine Care: a Narrative Synthesis of the Literature

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