The future of telehealth in type 1 diabetes

Abstract

Purpose of reviewAlthough telemedicine and telehealth services have been a part of type 1 diabetes (T1D) clinical care for several decades, the expansion of in-home telemedicine during the COVID-19 pandemic significantly increased interest in long-term use as part of routine care. This review highlights the current literature regarding telemedicine in T1D care as well as the benefits and barriers to use in a postpandemic world. Recent findingsTelemedicine has increased patient contact with healthcare providers, allowing for more frequent insulin dose adjustments and improvements in glycemic outcomes. In addition to routine clinical care, T1D device training and mental healthcare have been successful through telemedicine. Significant barriers to continued telemedicine care exist, including patient access and technology knowledge, language, and loss of face-toface interaction. Healthcare providers additionally face unpredictable reimbursement and loss of continuity across state lines, and lack of resources and training for device downloads and telemedicine software.

Telemedicine management of type 2 diabetes mellitus in obese and overweight young and middle-aged patients during COVID-19 outbreak: A single-center, prospective, randomized control study

“…Telemedicine refers to remote diagnosis, treatment, and consultation of patients using remote communication, digital holography, modern electronic technology, and computer multimedia [ 8 ]. It allows the patient to avail full benefits of medical technology and equipment available at higher medical centers as well as receive disease-related counseling and education when social interaction or direct contact with the healthcare providers is not possible [ 9 ].…”

Telehealth model versus in-person standard care for persons with type 1 diabetes treated with multiple daily injections: an open-label randomized controlled trial

“…In this sense, it is necessary to make some clarifications. First, the cost value assigned to virtual visits has been calculated on an approximate basis, since their real value has yet to be recatalogued after the COVID-19 pandemic has caused this type of visit to increase significantly ( 14 ). On the other hand, the visit made in person in the sixth month to the TH group was carried out as part of the protocol to determine the anthropometric variables and close the trial.…”

“…This last point has been even more important in rural zones, such as our area in Alt Penedès, where distances are longer and time spent traveling is greater. In addition, the coronavirus disease 2019 (COVID-19) pandemic highlighted TH as a need, given the increased risk of virus infection in in-person care at hospitals and traveling restrictions ( 12 – 14 ).…”

Diabetes care practices and outcomes in 40.000 children and adolescents with type 1 diabetes from the SWEET registry during the COVID-19 pandemic

“…Medical teams, including multidisciplinary teams for diabetes care, addressed these challenges [4] , [5] , [6] . Traditional models of diabetes care once delivered routinely in person, were forced to adopt a diverse array of ad hoc solutions during the pandemic [7] , [8] .…”

“…Over the past few years, a significant increase in telemedicine use (also: digital/virtual clinic, remote monitoring, and telecare) in pediatric diabetes care has been observed. Advances in continuous glucose monitoring (CGM) technology, increased clinical uptake, and cloud-based data exchange, have decisively contributed to and accelerated this advancement [8] , [9] and were swiftly incorporated in many institutions with the pandemic outbreak [4] , [10] , [11] .…”