Managing New-Onset Type 1 Diabetes During the COVID-19 Pandemic: Challenges and Opportunities
Managing New-Onset Type 1 Diabetes During the COVID-19 Pandemic: Challenges and Opportunities
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DOI：
10.1089/dia.2020.0161
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发表时间：
2020-04-17
影响因子：
5.4
通讯作者：
Forlenza, Gregory P.
中科院分区：
文献类型：
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作者：
Garg, Satish K.;Rodbard, David;Forlenza, Gregory P.
背景：当前的COVID-19大流行为大幅扩大远程医疗在高危糖尿病患者中的应用提供了动力，特别是在1型糖尿病（T1D）的管理中。远程医疗和数字医疗还为改善糖尿病患者医疗服务的可及性、疗效、效率和成本效益提供了至关重要的途径。方法：介绍2例远程医疗在第1天患者亲自教育后有效、安全使用的病例报告。新发T1D患者（成人和儿童）管理的这些方面包括对患者和家属进行数字化的糖尿病教育。患者使用市售分析软件（Dexcom Clarity和gloko）进行连续血糖监测，生成动态血糖谱和解释性总结报告。成人受试者每天多次注射胰岛素；儿科患者使用胰岛素泵。研究人员通过电子邮件、Zoom网络和电话等多种方式对研究对象进行管理。结果：这两个病例显示了远程医疗在新发糖尿病教育和胰岛素剂量管理方面的可行性和有效性。结论：本病例报告说明了远程医疗如何安全有效地用于儿科和成人患者及其家属的新发T1D培训和教育。2019冠状病毒病大流行严重刺激了远程医疗和数字医疗的使用。我们得出结论，远程医疗是管理新发T1D患者的有效方法。
Background: The current COVID-19 pandemic provides an incentive to expand considerably the use of telemedicine for high-risk patients with diabetes, and especially for the management of type 1 diabetes (T1D). Telemedicine and digital medicine also offer critically important approaches to improve access, efficacy, efficiency, and cost-effectiveness of medical care for people with diabetes.Methods: Two case reports are presented where telemedicine was used effectively and safely after day 1 in person patient education. These aspects of the management of new-onset T1D patients (adult and pediatric) included ongoing diabetes education of the patient and family digitally. The patients used continuous glucose monitoring with commercially available analysis software (Dexcom Clarity and Glooko) to generate ambulatory glucose profiles and interpretive summary reports. The adult subject used multiple daily insulin injections; the pediatric patient used an insulin pump. The subjects were managed using a combination of e-mail, Internet via Zoom, and telephone calls.Results: These two cases show the feasibility and effectiveness of use of telemedicine in applications in which we had not used it previously: new-onset diabetes education and insulin dosage management.Conclusions: The present case reports illustrate how telemedicine can be used safely and effectively for new-onset T1D training and education for both pediatric and adult patients and their families. The COVID-19 pandemic has acutely stimulated the expansion of the use of telemedicine and digital medicine. We conclude that telemedicine is an effective approach for the management of patients with new-onset T1D.