Telemonitoring type 1 diabetes patients during the COVID-19 pandemic in Brazil: was it useful?

Abstract

Objectives: To evaluate the performance of telemonitoring in detecting clinical and psychological needs and adherence to the protective measures imposed by the COVID-19 pandemic in addition to providing remote assistance for patients with type 1 diabetes (T1D) in a public university center in Brazil. Subjects and methods: Telemonitoring protocol included phone calls and e-mails. Patients were asked to rate COVID-19-like symptoms, psychological symptoms, epidemiological issues, and adherence to diabetes management (insulin, exercise, and diet) using a 0-to-10 scale. An e-mail address and phone number were offered for further contact if needed. Clinical, demographic, and laboratorial data from the consultations before the pandemic were collected from medical records. Results: Among 321 patients with a previously scheduled consultation over the first 15 weeks of social distancing, 237 (73.8%) could be successfully contacted. Of these, 207 (87.3%) were exclusively evaluated by telemonitoring (190 only by phone or text message and 17 who were also reached by email), and 30 (12.7%) patients attended the consultation for medical reasons detected during the telephone screening. Overall, 44 (18.5%) patients reported COVID-19-like symptoms. One (2.3%) patient was hospitalized and subsequently died. Psychological symptoms were reported by 137 (60.4%) patients and 30 (12.7%) required remote psychological assistance. Appropriate social distancing was performed by 203 (87.9%) patients, and 221 (97.8%) referred use of masks. Conclusions: Telemonitoring T1D patients during the pandemic helped reduce the need for in-person consultations, detect clinical and psychological needs, and offer support to patients in addition to monitoring suspected COVID-19 cases and the adherence to protective measures.

Glucose control in diabetes during home confinement for the first pandemic wave of COVID-19: a meta-analysis of observational studies

“…In order to maintain basic care, telemonitoring was implemented in many countries [6][7][8]. Telematic interactions were also used to help patients in developing coping strategies for managing home confinement [9][10][11] and maintaining physical activity [12,13]. Physical activity is crucial in diabetes mellitus management, especially during a pandemic, as it enhances immune response to viral infections [14]; therefore, many efforts have been performed to help patients in finding strategies to maintain it during lockdown [15].…”

Diabetes self-care practices and resilience in the Brazilian COVID-19 pandemic: results of a web survey: DIABETESvid

“…This may involve providing care out of the traditional settings by using virtual health resources to disseminate information and maximize health care services for the population by means of community health agents [ 32 ]. Studies show that the follow-up of people with diabetes by using telemedicine is favourable as it enables the detection of clinical and psychological needs and provides support to the patients, including significant improvement in glycaemic levels [ 33 , 34 ]. In our sample, 31.7% participants receive care through telemedicine, and of these, 39.6% were individuals with DM1.…”

Digital technologies in the care of people with diabetes during the COVID-19 pandemic: a scoping review

“…Moreover, more than half of the selected studies reveal that remote monitoring, with the help of integrated web platforms, is an important tool to ensure the glycemic range at an adequate level among children, adolescents and young adults with 1DM (15,(17)(18)(21)(22)(25)(26)(29)(30)(31)(33)(34) . Accordingly, a prospective observational study showed that structured virtual visits adequately maintain preexisting glycemic management or improve time in the target range among individuals with 1DM during an emergency, when one-to-one consultations are not allowed (35) .…”