Telehealth Supports Type 1 Diabetes Management Among Pediatric Patients

Researchers found that increases in the use of telehealth and continuous glucose monitors (CGMs) likely helped mitigate the impacts of the COVID-19 pandemic on hospitalization frequency, glycemic control, and depression incidence among pediatric type 1 diabetes patients.

During the COVID-19 pandemic, people from various demographics suffering from chronic conditions experienced difficulties obtaining in-person care.

A study published in BMC Pediatrics aimed to assess how the pandemic affected type 1 diabetes patients at a large, urban, pediatric, teaching hospital.

Researchers examined various factors, including patient characteristics, glycemic control, and PHQ-9 depression screening, and CGM utilization, in around 1,600 pediatric type 1 diabetes patients in one-year periods before and after the COVID-19 pandemic.

The study shows that there was no difference in these factors between the pre-and post-pandemic groups. They also found that among both commercially and non-commercially insured patients, who gained expanded access to CGMs during the pandemic, there was no change in the frequency of hospitalization between 2019 and 2020.

But researchers used a generalized linear model and found that older patients, those covered under non-commercial insurance, those of Black and Hispanic Race/Ethnicity, and non-users of CGMs were linked to high hemoglobin A1C.

Researchers surmised that the sharp increase in the use of telehealth and CGM during the COVID-19 pandemic may have helped keep hospitalizations, glycemic control and incidence of depression the same among pediatric patients with type 1 diabetes before and during the pandemic.

There were several limitations of the study, such as collecting observations from only one center, limited before-and-after data on factors that could have changed throughout the pandemic, and the use of insurance status to represent socioeconomic status.

Various studies throughout the COVID-19 pandemic have indicated that telehealth can support chronic disease management.

For example, a study from September 2021 indicated that telehealth played a role in both assisting children with chronic conditions and reducing health system costs. Despite hesitancy from patients and their families initially, the use rate of telehealth gradually grew.

A study published in March found that multiple sclerosis (MS) patients were satisfied with telehealth during the COVID-19 pandemic. After comparing demographics and telehealth use rates among both MS patients and healthy controls, researchers found that MS patients had lower COVID-19 exposure rates and a higher telehealth use rate, indicating high levels of approval from this population.

Another recent study found that pediatric patients suffering from chronic conditions used telehealth heavily. After collecting data, researchers revealed that factors such as parents’ education level, income, and living locations all had an impact on the use of telehealth, as did the presence of chronic conditions such as asthma or a developmental disorder.