A Virtual Training Program for the Tandem t:slim X2 Insulin Pump: Implementation and Outcomes

Abstract

Insulin pump training has traditionally been performed in-person. The coronavirus disease 2019 (COVID-19) pandemic necessitated vast increases in the number of virtual pump trainings for Tandem t:slim X2 insulin pump starts. A customized structured pump training curriculum specifically tailored to virtual learning was deployed in early 2020, and included (1) preparation for training with use of the t:simulator app, (2) use of the teach-back method during video training, and (3) automating data uploads for follow-up. Retrospective analysis from >23,000 pump training sessions performed from January 1, 2020 to July 28, 2020 showed sensor time-inrange for up to 6 months after training was 72% (60%-81%) for virtual training versus 67% (54%-78%) for inperson training. Higher user satisfaction (4.78 -0.52 vs. 4.64 -0.68; P < 0.01) and higher user confidence (4.61 -0.75 vs. 4.47 -0.0.85; P < 0.01) were reported after the virtual sessions. Virtual pump training was well received and proved safe and effective with the new virtual training curriculum.

Trends in Glycemic Control Among Youth and Young Adults With Diabetes: The SEARCH for Diabetes in Youth Study

“…Historically, structured, person-centered, and empowerment-based education programs for diabetes self-management and diabetes technology use have been delivered mostly in-person by a certified diabetes specialist. With the expansion of telehealth services during the coronavirus disease 2019 pandemic, virtual training sessions to provide diabetes education and start diabetes technology have been shown to be feasible (27)(28)(29)(30). The benefits of virtual training can include scheduling flexibility, access to individuals who live in more remote locations, and reaching individuals who experience challenges traveling to appointments and thus help to alleviate health equity issues (29).…”

Current provision and HCP experiences of remote care delivery and diabetes technology training for people with type 1 diabetes in the UK during the COVID‐19 pandemic

“…Remote technology starts were reported to be quite effective by respondents of this survey. Although there is a dearth of evidence on the efficacy of virtual pump training, encouraging results were reported in recent industry‐sponsored studies analysing the outcomes of virtual training on two different systems 23–25 . Of note, two of these studies were conducted in the United States where industry representatives alone tend to deliver device education in the absence of representatives from their local diabetes clinic.…”

“…Although there is a dearth of evidence on the efficacy of virtual pump training, encouraging results were reported in recent industry-sponsored studies analysing the outcomes of virtual training on two different systems. [23][24][25] Of note, two of these studies were conducted in the United States where industry representatives alone tend to deliver device education in the absence of representatives from their local diabetes clinic. They may be also confounded by the fact that digital literacy may be higher in private/insurance driven models of care.…”

ISPAD Clinical Practice Consensus Guidelines 2022: The delivery of ambulatory diabetes care to children and adolescents with diabetes

“…Historically, structured, person‐centered, and empowerment‐based education programs for diabetes technology use have been delivered mostly in‐person by a certified diabetes specialist. With the expansion of telehealth services during the COVID‐19 pandemic, virtual training sessions to start diabetes technology have been shown to be feasible since CGM and insulin pump data can be uploaded from home and accessed remotely by care teams 154–157 …”

“…Despite the rapid integration of diabetes technology into pediatric diabetes care, there continue to be multiple barriers to the uptake, use, and to be feasible since CGM and insulin pump data can be uploaded from home and accessed remotely by care teams. [154][155][156][157] Since multiple caregivers are generally involved in a child's care (e.g., babysitters, daycare providers, school nurses, teachers), education and support must extend beyond the youth and family in pediatric diabetes care. In addition, routine clinic visits should be used to reevaluate the benefit being achieved by and the adequacy of use of the diabetes technology by the medical provider.…”