Background: Telemedicine is a resource to provide health care to patients social distancing and prevent their exposure to the risk of contamination by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in medical-hospital settings. This study evaluated a virtual model of care in acromegalic patients. Methods: We recruited 78 acromegalic patients, 65% female, median age 63 years. Outpatient management was remodeled to simplify access to care by (1) adoption of virtual meetings;(2) collection of blood samples at home; (3) abolishment of printed prescription and provision of electronic files directly to central pharmacy; and (4) drugs delivered to patients' home. Patients and physicians filled electronic surveys 48 h after each consultation.Results: The patients expressed satisfaction with convenience (91.1%), decreased wait time (85.1%), and saving money (79.2%) compared to face-to-face visits. Most patients felt supported by the medical team (89.1%) and kept the prescriptions updated (84.8%). The physicians reported resolutive appointments in 92.2% of cases, despite longer time to reach the patients and subsequent calls to complement missing information. Satisfaction and patient-provider relationship were maintained during the study, but the choice for virtual appointment for the next appointment fell from 78.7% to 34.8% after 6 months. Coronavirus disease 2019 (COVID-19) was confirmed in 13% of patients, mostly mild and moderate manifestations. Conclusion:Telemedicine is a tool for medical care in underserved populations, feasible even in low-income countries. This study suggests that it is difficult to sustain exclusive remote care for more than 6 months. The method could be adopted interchangeably with in-person consultations in acromegalic patients with stable disease.

A hiperglicemia durante a gestação é condição frequente e está relacionada a múltiplas complicações materno-infantis. Depois do primeiro trimestre, período marcado por relativa sensibilidade à insulina, o crescimento da placenta promove a liberação de hormônios contrarreguladores da insulina permitindo que as hiperglicemias sobrevenham na gestante susceptível. A despeito dos enormes avanços farmacológicos no tratamento do diabetes, a insulinoterapia é a modalidade de escolha para as gestantes, considerando-se o perfil de segurança e escassez de estudos de longo prazo com outras drogas. As recomendações para o tratamento do diabetes gestacional e pré-gestacional são baseadas na opinião de especialistas e na experiência do serviço. O objetivo deste estudo é descrever a experiência do serviço de Endocrinologia e Metabologia do Hospital Universitário de Brasília no manejo de gestantes com diabetes, bem como apresentar uma abordagem prática de insulinização nessas pacientes. ABSTRACTHyperglycaemia during pregnancy is a frequent condition and is related to many maternal-infant complications. After the first trimester, a period marked by relative insulin sensitivity, placental growth promotes the release of insulinregulating hormones, allowing hyperglycaemia to occur in the susceptible pregnant woman. In spite of the enormous pharmacological advances in the treatment of diabetes, insulin therapy is the modality of choice for pregnant women, considering the safety profile and shortage of long-term studies with other drugs. Recommendations for the treatment of gestational and pre-gestational diabetes are based on the opinion of experts and the experience of the service. The objective of this study is to describe the experience of the Endocrinology and Metabolism Service of the University Hospital of Brasília in the management of pregnant women with diabetes as well as to present a practical approach on how to use insulin in these patients.