Telehealth Helped Maintain Type 1 Diabetes Care Among Kids During Pandemic

The utilization of telehealth devices, such as continuous glucose monitors (CGMs), helped providers continue to care for children with type 1 diabetes as the COVID-19 pandemic upended healthcare delivery, a study from BMC Pediatrics found.

The study took place at the Children's Medical Center in Dallas, which has 487 beds. Researchers collected pre-COVID data from 2019 and post-COVID statistics from 2020.

The data collection included several factors, such as age, insurance status, race and ethnicity, and CGM utilization level. Using a variety of statistical analyses, researchers noticed several differences when comparing data from 2019 to 2020.

Between 2019 and 2020, outpatient visits decreased among pediatric type 1 diabetics with commercial insurance, but not non-commercial insurance.  with commercial insurance but not for patients with non-commercial insurance.

Researchers also noticed that patients of older age, those who were Black and Hispanic, those who had non-commercial insurance, and those who did not use CGMs had high glycemic control. Despite these results, numbers regarding high HbA1c did not vary between 2019 and 2020.

Unlike patients with commercial insurance, the use of CGM increased significantly among non-commercial insurance members, rising from 24.5 percent in 2019 to 35.7 percent in 2020.

Before the COVID-19 pandemic, the hospital also closely monitored depression rates. The number of screened patients decreased from 58.5 in 2019 to 41.5 percent in 2020. Researchers believe this was because telehealth services did not include a questionnaire regarding depression.

Researchers concluded that the COVID-19 pandemic significantly impacted glycemic control among diabetic patients. Those with a higher hemoglobin A1c (HbA1c), racial minorities, and those with non-commercial insurance were more likely to have high rates of diabetic ketoacidosis.

But the implementation of telehealth and CGMs increased parental oversight, allowing for a steady rate of care and maintenance of a lower hospitalization rate.

Though the size and diversity of the sample were a major strength of the study, retrieving statistics from a single urban location may have skewed data.

Regardless, researchers acknowledged that "increased adoption of continuous glucose monitors and extensive use of telemedicine visits may have ameliorated the impact of the pandemic on disease management."

Like type 1 diabetes patients, type 2 diabetes patients also experienced many benefits from telehealth use during the COVID-19 pandemic. A study published in December 2021 revealed that various telehealth strategies assisted in lowering hemoglobin A1C levels. Further, providers found it very easy to virtually communicate with type 2 diabetes patients.

During the pandemic, remote patient monitoring (RPM) was also conducive to caring for type 2 diabetes. A study from October 2021 revealed the success of a pharmacist-managed RPM platform. The service helped reduce A1c levels among type 2 diabetes patients and enhanced communication.