Is Telemedicine the Preferred Visit Modality in Patients with Type 1 Diabetes?

Abstract

Background The COVID-19 pandemic limits access to diabetes clinics. Remote communication by phone calls and WhatsApp messages became available in the past years. However, the current need to avoid face-to-face meetings necessitates further expansion of telemedicine services. There are limited data whether the option of virtual meetings is a preferred therapeutic modality for patients with type 1 diabetes (T1D).

Objective To assess in a cohort of T1D patients, their preference and perception of telemedicine.

Methods T1D patients who are followed in a hospital-affiliated diabetes clinic were asked to fill a structured questionnaire aimed to determine their attitude towards telemedicine and their preference of virtual versus conventional visits. The questionnaire was offered to consecutive T1D patients who visited the clinic between August to October 2020.

Results Seventy one T1D patients that fulfilled the questionnaire were included. Median age was 38 years, 39% were male, and median duration of diabetes was 18 years. Fourteen percent of the participants preferred only virtual visits, 24% only conventional visits and 62% preferred a combination of these modalities. Sex, origin, education, duration of diabetes, mode of insulin treatment and distance from the clinic were not associated with patients' preference, but older patients (≥ 61 years) tended to prefer conventional visits. Sixty-six percent felt confident in their ability to download data from their personal medical devices.

Conclusions Patients from a wide range of treatment modalities are willing to use telemedicine. However, virtual meetings cannot fully replace conventional visits in T1D especially in the older age group.

Publication History

Received: 11 March 2021
Received: 02 June 2021

Accepted: 15 June 2021

Article published online:
22 July 2021

• References

• 1 Chowdhury S, Goswami S. COVID-19 and type 1 diabetes: Dealing with the difficult duo. Int J Diabetes in Dev Ctries 2020; 40: 315-320
• 2 Scott SN, Fontana FY, Zuger T. et al. Use and perception of telemedicine in people with type 1 diabetes during the COVID-19 pandemic-results of a global survey. Endocrinol Diabetes Metab 2020; 4: 1 e00180
• 3 Venkatesh N, Paldus B, Lee MH. et al. COVID-19, Type 1 diabetes clinical practice, research, and remote medical care: A view from the land down-under. J Diabetes Sci Technol 2020; 14: 803-804
• 4 Powell PW, Corathers SD, Raymond J. et al. New approaches to providing individualized diabetes care in the 21st century. Curr Diabetes Rev 2015; 11: 222-230
• 5 Renard E. Personal experience with COVID-19 and diabetes in the south of France: technology facilitates the management of diabetes in disruptive times. J Diabetes Sci Technol 2020; 14: 772-773
• 6 Nørgaard K. Telemedicine consultations and diabetes technology during COVID-19. J Diabetes Sci Technol 2020; 14: 767-768
• 7 Vigersky RA, Velado K, Zhong A. et al. The effectiveness of virtual training on the MiniMed 670G system in people with type 1 diabetes during the COVID-19 pandemic. Diabetes Technol Ther 2021; 23: 104-109
• 8 Krismas E, Sibomana L. Benefits of technology in the age of COVID-19 and diabetes…Mobile phones from a Rwanda perspective. J Diabetes Sci Technol 2020; 14: 748-749
• 9 Garg SK, Rodbard D, Hirsch IB. et al. Managing new-onset type 1 diabetes during the COVID-19 pandemic: Challenges and opportunities. Diabetes Technol Ther 2020; 22: 431-439
• 10 Peters AL, Garg SK. The silver lining to COVID-19: Avoiding diabetic ketoacidosis admissions with telehealth. Diabetes Technol Ther 2020; 22: 449-453
• 11 Mesa A, Vinals C, Pueyo I. et al. The impact of strict COVID-19 lockdown in Spain on glycemic profiles in patients with Type 1 diabetes prone to hypoglycemic using standalone continuous glucose monitoring. Diabetes Res Clin Pract 2020; 167: 108354
• 12 Parise M, Tartaglione L, Cutruzzola A. et al. Teleassistance for patients with type 1 diabetes during the COVID-19 pandemic: results of a pilot study. J Med Internet Res 2021; 23: e24552
• 13 Bonora BM, Boscari F, Avogaro A. et al. Glycaemic control among people with type 1 diabetes during lockdown for the SARS-CoV-2 outbreak in Italy. Diabetes Ther 2020; 11: 1369-1379
• 14 Fernandez E, Cortazar A, Bellido V. Impact of covid-19 lockdown on glycemic control in patients with type 1 diabetes. Diabetes Res Clin Pract 2020; 166: 108348
• 15 Luzi L, Carruba M, Crialesi R. et al. Telemedicine and urban diabetes during COVID-19 pandemic in Milano, Italy during lock-down: Epidemiological and sociodemographic picture. Acta Diabetol 2021; 1-9
• 16 Meckai K, Smith N, Stern AD. et al. Remote patient monitoring-overdue or overused?. N Engl J Med 2021; 384: 1384-1386
• 17 Odeh R, Gharaibeh L, Daher A. et al. Caring for a child with type 1 diabetes during COVID-1 lockdown in a developing country: Challenges and parents’ perspectives on the use of telemedicine. Diabetes Res Clin Pract 2020; 168: 108393
• 18 Xu T, Pujara S, Sutton S. et al. Telemedicine in the management of type 1 diabetes. Prev Chronic Dis 2018; 15: e13