Role of telemedicine during COVID-19 pandemic in type 2 diabetes outpatients: The AMD annals initiative

Russo, Giuseppina T.; Andreozzi, Francesco; Calabrese, Mariella; Bartolo, Paolo Di; Cianni, Graziano Di; Giorda, Carlo; Lapice, Emanuela; Manicardi, Elisa; Giandalia, Annalisa; Lucisano, Giuseppe; Nicolucci, Antonio; Rocca, Alberto; Rossi, Maria Chiara; Spreafico, Emanuele; Vespasiani, G; Manicardi, Valeria

doi:10.1016/j.diabres.2022.110158

Cited by 12 publications

(10 citation statements)

References 25 publications

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“…5 In single-center studies in Romania, Saudi Arabia, and China, telehealth use during the pandemic appeared to be associated with improvements in glucose control, although most studies were limited to less than 6 months of follow-up, excluding the Romanian study which included 12 months of follow-up. [6][7][8] Evaluation of the extent to which the COVID-19 pandemic impacted the use of telehealth and diabetes management over a longer follow-up time is needed. Furthermore, whether telehealth access is equitable among subgroups of the population has not yet been explored.…”

Section: How This Studymentioning

confidence: 99%

“…In contrast, an Italian study among people with type 2 diabetes reported that telehealth was linked to less frequent screenings of long-term complications (ie, retinopathy, CVD, myocardial infarction, stroke, foot complications, eGFR <60 mL/min, and dialysis) 5. In single-center studies in Romania, Saudi Arabia, and China, telehealth use during the pandemic appeared to be associated with improvements in glucose control, although most studies were limited to less than 6 months of follow-up, excluding the Romanian study which included 12 months of follow-up 6–8. Evaluation of the extent to which the COVID-19 pandemic impacted the use of telehealth and diabetes management over a longer follow-up time is needed.…”

Section: Introductionmentioning

confidence: 99%

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Access to telehealth and changes in diabetes care patterns during the pandemic: evidence from a large integrated health system in the Southeast USA

Oviedo,

McDonald,

Gander

et al. 2024

BMJ Open Diab Res Care

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IntroductionTo examine the role of telehealth in diabetes care and management during versus pre-COVID-19 pandemic.Research design and methodsWe included adults (≥18 years) with prevalent diabetes as of January 1, 2018, and continuously enrolled at Kaiser Permanente Georgia through December 31, 2021 (n=22,854). We defined pre (2018–2019) and during COVID-19 (2020–2021) periods. Logistic generalized estimating equations (GEEs) assessed the within-subject change in adherence to seven annual routine care processes (blood pressure (BP), hemoglobin A1C (HbA1c), cholesterol, creatinine, urine-albumin-creatinine ratio (UACR), eye and foot examinations) pre versus during COVID-19 among telehealth users (ie, more than one telehealth visit per year per period) and non-telehealth users. Linear GEE compared mean laboratory measurements pre versus during COVID-19 by telehealth use.ResultsThe proportion of telehealth users increased from 38.7% (2018–2019) to 91.5% (2020–2021). During (vs pre) the pandemic, adherence to all care processes declined in telehealth (range: 1.6% for foot examinations to 12.4% for BP) and non-telehealth users (range: 1.9% for foot examinations to 40.7% for BP). In telehealth users, average HbA1c (mean difference: 0.4% (95% CI 0.2% to 0.6%), systolic BP (1.62 mm Hg (1.44 to 1.81)), and creatinine (0.03 mg/dL (0.02 to 0.04)), worsened during (vs pre) COVID-19, while low density lipoprotein (LDL) cholesterol improved (−9.08 mg/dL (−9.77 to −8.39)). For UACR, odds of elevated risk of kidney disease increased by 48% (OR 1.48 (1.36–1.62)). Patterns were similar in non-telehealth users.ConclusionsTelehealth use increased during the pandemic and alleviated some of the observed declines in routine diabetes care and management.

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Section: How This Studymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Access to telehealth and changes in diabetes care patterns during the pandemic: evidence from a large integrated health system in the Southeast USA

Oviedo,

McDonald,

Gander

et al. 2024

BMJ Open Diab Res Care

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“…The studied population is representative of patients followed at diabetes centers in Italy according to a recent large survey in T2DM [40] but could not be representative of the general population with diabetes. In this study the percentage of CAN in T2DM was lower than expected also compared to T1DM group.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Does the Relationship of the Autonomic Symptoms Questionnaire COMPASS 31 with Cardiovascular Autonomic Tests Differ between Type 1 and Type 2 Diabetes Mellitus?

D’Ippolito,

Menduni,

D’Amato

et al. 2024

Diabetes Metab J

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Background:The aim was to investigate if autonomic symptoms questionnaire Composite Autonomic Symptom Score (COM-PASS) 31 has different association with cardiovascular autonomic neuropathy (CAN) and diagnostic performance between type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM). Methods: Seventy-nine participants with T1DM and 140 with T2DM completed COMPASS 31 before cardiovascular reflex tests (CARTs) for CAN, and assessment of symptoms, signs, vibration, and thermal perception thresholds for diabetic polyneuropathy (DPN) diagnosis. Results: COMPASS 31 total weighted score (TWS) was similar in the two groups, but significantly associated with confirmed CAN only in T1DM (P=0.0056) and not T2DM group (P=0.1768) and correlated with CARTs score more strongly in T1DM (rho=0.356, P=0.0016) than in T2DM group (rho=0.084, P=0.3218) (P=0.016). Only in T1DM and not T2DM group, the area under the receiver operating characteristic curve (AUC) reached a fair diagnostic accuracy (>0.7) for confirmed CAN (0.73±0.07 vs. 0.61±0.08) and DPN (0.75±0.06 vs. 0.68±0.05), although without a significant difference. COMPASS 31 TWS (cut-off 16.44) reached acceptable diagnostic performance in T1DM, with sensitivity for confirmed CAN 81.2% and sensitivity and specificity for DPN 76.3% and 78%, compared to T2DM group (all <70%). AUC for DPN of orthostatic intolerance domain was higher in T1DM compared to T2DM group (0.73±0.05 vs. 0.58±0.04, P=0.027). Conclusion: COMPASS 31 is more weakly related to CAN in T2DM than in T1DM, with a fair diagnostic accuracy for confirmed CAN only in T1DM. This difference supports a multifactorial origin of symptoms and should be considered when using COM-PASS 31.

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“…Table 3 summarizes the positive results on metabolic control and patient satisfaction obtained with telemedicine in various studies, both in patients with T1D and with T2D. The study by Russo et al [ 68 ] led in T2D patients showed that the group followed through telemedicine had a greater probability of displaying not only a better glycemic profile but also better metabolic parameters than the group followed with a face-to-face approach. Similarly, patients with T1D also seemed very satisfied with telemedicine during the pandemic, as reported in other studies[ 69 , 70 ].…”

Section: Telemedicinementioning

confidence: 99%

Multiple influences of the COVID-19 pandemic on children with diabetes: Changes in epidemiology, metabolic control and medical care

Zucchini¹,

Scozzarella²,

Maltoni³

2023

World J Diabetes

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The coronavirus disease 2019 (COVID-19) pandemic has heavily affected health worldwide, with the various forms of diabetes in children experiencing changes at various levels, including epidemiology, diabetic ketoacidosis rates and medical care. Type 1 diabetes showed an apparent increase in incidence, possibly owing to a direct damage of the virus to the β-cell. Diabetic ketoacidosis also increased in association with the general fear of referring patients to the hospital. Most children with diabetes (both type 1 and type 2) did not show a worsening in metabolic control during the first lockdown, possibly owing to a more controlled diet by their parents. Glucose sensor and hybrid closed loop pump technology proved to be effective in all patients with type 1 diabetes during the pandemic, especially because the downloading of data allowed for the practice of tele-medicine. Telemedicine has in fact grown around the world and National Health Systems have started to consider it as a routine activity in clinical practice. The present review encompasses all the aspects related to the effects of the pandemic on the different forms of diabetes in children.

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Role of telemedicine during COVID-19 pandemic in type 2 diabetes outpatients: The AMD annals initiative

Cited by 12 publications

References 25 publications

Access to telehealth and changes in diabetes care patterns during the pandemic: evidence from a large integrated health system in the Southeast USA

Access to telehealth and changes in diabetes care patterns during the pandemic: evidence from a large integrated health system in the Southeast USA

Does the Relationship of the Autonomic Symptoms Questionnaire COMPASS 31 with Cardiovascular Autonomic Tests Differ between Type 1 and Type 2 Diabetes Mellitus?

Multiple influences of the COVID-19 pandemic on children with diabetes: Changes in epidemiology, metabolic control and medical care

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