Virtual Training Suitable for Type 1 Diabetes Patients

A major byproduct of the ongoing COVID-19 pandemic has been the adoption of telemedicine tools to help patients while reducing the need and risk of in-person medical appointments.

In data presented during the American Diabetes Association 2021 Virtual Meeting, researchers examined how virtual training helped patients with type 1 diabetes.

Even with recent technological advances, researchers have yet to close the gap in discovering optimal glycemic control for patients with type 1 diabetes. However, hybrid closed loop systems equipped with automated algorithm-derived adjustments of basal insulin delivery could improve this without adding additional therapeutic burdens or educational investments.

A team, led by Adrian E. Proietti, evaluated the effectiveness of HCL systems in type 1 diabetes patients in Latin America who received a virtual training.

The Study

In the prospective observational data analysis, the researchers examined 104 consecutive patients with type 1 diabetes that initiated treatment with MiniMed™ 670G system in Argentina. The average age of the patient population was 32.8 and each patient was previously on MDI+SMBG (26%), MDI+isCGM (12.5%), CSII+SMBG (9.6%), CSII+isCGM (2.9%), and SAP-TS (49%).

The baseline GMI was 7.3 ± 0.8%.

The researchers conducted baseline and follow-up visits at day 28, 90, and 180. Training and follow-up was performed completely virtual. The time in range 70-180 mg/dl significantly increased regardless of prior therapy from 62.1±14.8 % at baseline to 74.6±8.6 %, 74.2±9.8 % and 74.3±9.6 % at days 28, 90 and 180 respectively (P <0.05).

In addition, mean glucose levels decreased from 166.1mg/dL at baseline to 152.9 mg/dL (P <0.05) at day 180 and GMI was reduced from 7.3% to 6.9% (P <0.05).

The sensor wear time and Auto Mode use was 89.1% and 88.6%, respectively, at the conclusion of the study.

“Our findings confirm that the use of MiniMed™ 670 System allows patients to achieve glycemic control within recommended targets in a non-selected population in Argentina,” the authors wrote. “Virtual education appears to be suitable for patient training on HCL therapy during current COVID-19 pandemic situation.”

Telemedicine During COVID-19

Earlier this year, a survey revealed significant satisfaction with telehealth visits among endocrinology providers and patients.

In fact, many patients with chronic endocrine health problems who required close monitoring indicated a desire to continue telemedicine follow-up visits following the end of the pandemic.

Among the patients surveyed, 65% expressed they would like to continue with telemedicine after the pandemic. Furthermore, 42% of patients preferred video visits, while 37% preferred phone calls. As many as 77% indicated that the quality of care with telemedicine, regardless of modality, was almost the same as in-person visits.

In terms of time spent in visit, 45% said they liked spending less time with telemedicine.

A majority (54%) noted that the duration of their telemedicine visit was about the same as in-person, and yet 54% also believed they spent less time with telemedicine.

Even more, an overwhelming majority (90%) indicated that all their questions and concerns were addressed through telemedicine.

However, a smaller proportion of patients reported no connectivity issues (37%) or technical difficulties (25%).

The study, “Six-Month Glycemic Control with a Hybrid Closed-Loop System in Type 1 Diabetes Patients during COVID-19 Pandemic in Argentina,” was published online by ADA.