A Systematic Review of Pediatric Telediabetes Service Models

Abstract

Telediabetes may improve patient access to clinicians who specialize in the management of pediatric diabetes. Due to the diversity of telehealth modes, many different service models for pediatric telediabetes have been developed. This review describes pediatric telediabetes service models identified in the literature, investigates the reported changes in HbA1c of these interventions, and describes enablers and barriers to implementing a telediabetes service. Evaluation of current literature may inform the development and sustainability of telehealth services for pediatric diabetes management. Twenty-nine studies met inclusion criteria and were reviewed. This review has demonstrated that pediatric telediabetes can be delivered by remote monitoring and real-time videoconference modes. Overall, pediatric telediabetes increased interactions between patients and clinicians, improved access to specialized care, and facilitated increased diabetes monitoring. In some contexts, telediabetes also improved short-term glycemic control. Key enablers reported for telediabetes services were integration with existing workflows, dedicated staff, clinician and patient training, appropriate data security, technology with good usability, and the availability of technical support. Barriers included increases in patient responsibilities and clinician workload, and technical issues with equipment and software.

Assessing the benefits and challenges of video consultations for the treatment of children with type 1 diabetes – A qualitative study among diabetes professionals

“…The main results are in line with a recent systematic review published by De Guzman et al [4] on 29 telemedicine studies in the field of paediatric diabetes care. The majority of these studies focussed on metabolic outcomes, while only few assessed participants' or professionals' satisfaction.…”

“…as being discussed face-to-face. Recent studies have shown that telemedicine in diabetes care might improve self-management, therapy engagement, and metabolic outcomes [1,3,4]. It is assumed that patients and diabetes teams have positive attitudes about video consultation if they have the means to set it up technically and carry it out.…”

Use and perception of telemedicine in people with type 1 diabetes during the COVID‐19 pandemic—Results of a global survey

“…While discussions about remote telemedicine are rapidly increasing due to the pandemic, a number of studies have previously investigated the potential benefits of telemedicine in diabetes care 6,9,10 . In a systematic review of 29 studies in the field of paediatric diabetes care, 7 it was concluded that telemedicine has the potential to facilitate patient monitoring and can improve short‐term glycaemic control in some contexts. It has also been suggested that virtual diabetes care may prove effective in aiding behavioural change, as well as providing social and psychological support 11 .…”

Evaluation of telephone and virtual visits for routine pediatric diabetes care during the COVID-19 pandemic

“…Usability refers to the extent to which a product is used “to achieve specified goals with effectiveness, efficiency and satisfaction in a specified context” [10] . Usability has been identified as an enabler of successful telehealth care, and may reduce burden on patients and clinicians [11] ; however, there remains limited information about the usability of virtual technologies for pediatric patients and their families, especially during a pandemic.…”