Download PDF
Diabetologie und Stoffwechsel 2024; 19(04): 281-287
DOI: 10.1055/a-2276-3420
Originalarbeit

Die COVID-19-Pandemie als Katalysator für telemedizinische Therapieangebote: eine Studie über Kinder und Jugendliche mit Diabetes mellitus Typ 1 in Deutschland und Österreich

The COVID-19 pandemic as a catalyst for telemedicine treatment options: a study on children and adolescents with type 1 diabetes in Germany and Austria
Katharina Klauser
1   Sozialpädiatrisches Zentrum Garmisch-Partenkirchen, Deutsches Zentrum für Kinder- und Jugendrheumatologie, Garmisch-Partenkirchen, Germany (Ringgold ID: RIN219615)
,
Julian Ziegler
2   Universitätsklinikum Tübingen, Universitätsklinikum Tübingen Klinik für Kinder- und Jugendmedizin, Tubingen, Germany (Ringgold ID: RIN219612)
,
Petra Augstein
3   Klinik für Diabetologie, Klinikum Karlsburg Herz- und Diabeteszentrum, Karlsburg, Germany
,
Stefanie Schmid
4   CAQM, Universität Ulm Institut für Epidemiologie und Medizinische Biometrik, Ulm, Germany (Ringgold ID: RIN221547)
,
Simone von Sengbusch 
5   Klinik für Kinder und Jugendmedizin, Universitatsklinikum Schleswig Holstein - Campus Lubeck, Lubeck, Germany (Ringgold ID: RIN54360)
,
Felix Reschke
6   Kinder- und Jugendkrankenhaus Auf der Bult, Hannover, Diabetes Centre for Children and Adolescents, Hannover, Germany
,
Angela Galler
7   corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Sozialpädiatrisches Zentrum, Charité Universitätsmedizin Berlin, Berlin, Germany (Ringgold ID: RIN14903)
,
Sabine E Hofer
8   Department für Pädiatrie 1, Medizinische Universität Innsbruck, Innsbruck, Austria (Ringgold ID: RIN27280)
,
Silke Schmidt
9   Klinik für Kinder- und Jugendmedizin, Klinikum Dritter Orden, Munchen, Germany (Ringgold ID: RIN219636)
,
Marina Sindichakis
10   Klinik für Kinder- und Jugendmedizin Traunstein, Klinikum Traunstein, Traunstein, Germany (Ringgold ID: RIN15013)
,
Reinhard W. Holl
11   ZIBMT, Universität Ulm Institut für Epidemiologie und Medizinische Biometrik, Ulm, Germany (Ringgold ID: RIN221547)
› Author AffiliationsSupported by: Robert Koch Institut (RKI) 1368-1711
Supported by: Deutschen Zentrum für Diabetesforschung (DZD) 82DZD14E03
Supported by: Deutsche Diabetes Gesellschaft (DDG)
› Further Information
Also available at
    Permissions and Reprints

Zusammenfassung

Diese Studie untersucht die Anwendung und Effektivität telemedizinischer Angebote für Kinder und Jugendliche mit Diabetes mellitus Typ 1 zwischen 2018 bis 2022 und den Einfluss der COVID-19-Pandemie. Der Anteil telemedizinischer Kontakte zeigt eine deutliche Korrelation mit dem Verlauf der COVID-19-Pandemie und verbleibt postpandemisch auf höherem Niveau. Jüngere Patient*innen und Anwender*innen von Diabetes-Technologien oder ihre Familien nutzen verstärkt Telemedizin. Nutzer*innen von Telemedizin zeigten eine bessere Stoffwechseleinstellung. Die Mehrheit der telemedizinischen Angebote stammt von Klinikambulanzen, welche aufgrund ihrer Größe und Ressourcen möglicherweise besser dafür ausgestattet sind.

Abstract

The study examines the application and effectiveness of telemedicine services for children and adolescents with type 1 diabetes in Germany and Austria from 2018 to 2022, as well as the impact of the COVID-19 pandemic. The proportion of telemedicine contacts was closely correlated with the progression of the COVID-19 pandemic and remains elevated in the post-pandemic period. Younger patients and those utilizing diabetes technologies, along with their families, were more inclined to frequently use telemedicine. Users of telemedicine exhibited improved metabolic control. The majority of telemedicine services are provided in hospital outpatient clinics, likely due to their greater resources and capacity for telemedical care.

Schlüsselwörter

Diabetes mellitus Typ 1 - Kinder, Jugendliche - Telemedizin - COVID-19-Pandemie - Diabetesregister - Versorgungsforschung

Keywords

diabetes mellitus type 1 - pediatric care - telemedicine - COVID-19 pandemic - diabetes registry - health care research


Publication History

Received: 11 December 2023

Accepted after revision: 26 February 2024

Article published online:
25 March 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • Literatur

  • 1 Klonoff DC. Telemedicine for Diabetes: Current and Future Trends. J Diabetes Sci Technol 2015; 10: 3-5
    CrossrefPubMedSearch in Google Scholar
  • 2 Udsen FW, Hangaard S, Bender C. et al. The Effectiveness of Telemedicine Solutions in Type 1 Diabetes Management: A Systematic Review and Meta-analysis. J Diabetes Sci Technol 2023; 17: 782-793
    CrossrefPubMedSearch in Google Scholar
  • 3 Faruque LI, Wiebe N, Ehteshami-Afshar A. et al. Effect of telemedicine on glycated hemoglobin in diabetes: a systematic review and meta-analysis of randomized trials. CMAJ 2017; 189: E341-E364
    CrossrefPubMedSearch in Google Scholar
  • 4 Hanlon P, Daines L, Campbell C. et al. Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer. J Med Internet Res 2017; 19: e172
    CrossrefPubMedSearch in Google Scholar
  • 5 von Sengbusch S, Frielitz FS, Braune K. et al. Telemedizin in der Kinderdiabetologie. Diabetologe 2021; 17: 8
    CrossrefSearch in Google Scholar
  • 6 Kirzhner A, Zornitzki T, Ostrovsky V. et al. Is Telemedicine the Preferred Visit Modality in Patients with Type 1 Diabetes?. Exp Clin Endocrinol Diabetes 2022; 130 (07) 462-467
    Thieme ConnectPubMedSearch in Google Scholar
  • 7 von Sengbusch S, Doerdelmann J, Lemke S. et al. Parental expectations before and after 12-month experience with video consultations combined with regular outpatient care for children with type 1 diabetes: a qualitative study. Diabetic Medicine 2021; 38 (06) e14410
    CrossrefPubMedSearch in Google Scholar
  • 8 Frielitz FS, Doerdelmann J, Lemke S. et al. Assessing the benefits and challenges of video consultations for the treatment of children with type 1 diabetes – A qualitative study among diabetes professionals. Exp Clin Endocrinol Diabetes 2021; 12: 831-836
    Search in Google Scholar
  • 9 Bakhach M, Reid MW, Pyatak EA. et al. Home Telemedicine (CoYoT1 Clinic): A Novel Approach to Improve Psychosocial Outcomes in Young Adults With Diabetes. Diabetes Educ 2019; 45: 420-430
    CrossrefPubMedSearch in Google Scholar
  • 10 Crossen SS, Marcin JP, Qi L. et al. Home Visits for Children and Adolescents with Uncontrolled Type 1 Diabetes. Diabetes Technol Ther 2020; 22: 34-41
    CrossrefPubMedSearch in Google Scholar
  • 11 Reid MW, Krishnan S, Berget C. et al. CoYoT1 Clinic: Home Telemedicine Increases Young Adult Engagement in Diabetes Care. Diabetes Technol Ther 2018; 20: 370-379
    CrossrefPubMedSearch in Google Scholar
  • 12 Ryu S. Telemedicine: Opportunities and Developments in Member States: Report on the Second Global Survey on eHealth 2009 (Global Observatory for eHealth Series, Volume 2). Healthc Inform Res 2012; 18: 153-155
    CrossrefSearch in Google Scholar
  • 13 Eurostat. Statistics Explained. Glossary: Degree of urbanisation. 2015 Accessed August 13, 2021 at: https://ec.europa.eu/eurostat/statistics-explained/index.php/Glossary:Degree %20of%20urbanisation
    PubMedSearch in Google Scholar
  • 14 Haak T, Gölz S, Fritsche A. et al. Therapie des Typ-1-Diabetes. Der Diabetologe 2019; 15: 135-145
    CrossrefSearch in Google Scholar
  • 15 Schilling J, Tolksdorf K, Marquis A. et al. The different periods of COVID-19 in Germany: a descriptive analysis from January 2020 to February 2021. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2021; 64: 1093-1106
    PubMedSearch in Google Scholar
  • 16 Zucchini S, Scozzarella A, Maltoni G. Multiple influences of the COVID-19 pandemic on children with diabetes: Changes in epidemiology, metabolic control and medical care. World J Diabetes 2023; 14: 198-208
    CrossrefPubMedSearch in Google Scholar
  • 17 Blickwinkel: Was leisten Sprechstunden per Video?. Dtsch Arztebl 2024; 121: A-35-B-33
    Search in Google Scholar
  • 18 Lee JM, Ospelt E, Noor N. et al. T1D Exchange Quality Improvement Collaborative; Institutional Barriers to the Successful Implementation of Telemedicine for Type 1 Diabetes Care. Clin Diabetes 2023; cd230056
    CrossrefPubMedSearch in Google Scholar
  • 19 Prinz N, Holl RW. DPV-Registerdaten zur Versorgungslage von Menschen mit Diabetes. Accessed December 01, 2023 at: www.diabetologie-online.de/gesundheitsbericht-2024
  • 20 Wadwa RP, Reed ZW, Buckingham BA. et al. Trial of hybrid closed-loop control in young children with type 1 diabetes. N Engl J Med 2023; 388: 991-1001
    CrossrefPubMedSearch in Google Scholar
  • 21 Shah AC, Badawy SM. Telemedicine in Pediatrics: Systematic Review of Randomized Controlled Trials. JMIR Pediatr Parent 2021; 4: e22696
    CrossrefPubMedSearch in Google Scholar
  • 22 von Sengbusch S, Schneidewind J, Bokelmann J. et al. Monthly video consultation for children and adolescents with type 1 diabetes mellitus during the COVID-19 pandemic. Diabetes Res Clin Pract 2022; 193: 110135
    CrossrefPubMedSearch in Google Scholar
  • 23 Crossen SS, Romero CC, Loomba LA. et al. Patient perspectives on use of video telemedicine for type 1 diabetes care in the United States during the COVID-19 pandemic. Endocrines 2021; 2: 449-456
    CrossrefPubMedSearch in Google Scholar
  • 24 Xu T, Pujara S, Sutton S. et al. Telemedicine in the Management of Type 1 Diabetes. Prev Chronic Dis 2018; 15: E13
    CrossrefPubMedSearch in Google Scholar
  • 25 IDF AEI. Consensus statement on the worldwide standardisation of the HbA1c measurement. Diabetologia 2007; 50: 2042-2043
    CrossrefPubMedSearch in Google Scholar
  • 26 Rosenbauer J, Dost A, Karges B. et al. Improved metabolic control in children and adolescents with type 1 diabetes: a trend analysis using prospective multicenter data from Germany and Austria. Diabetes Care 2012; 35: 80-86
    CrossrefPubMedSearch in Google Scholar