Telemedicine for the Management of Diabetic Patients in a High-complexity Latin American Hospital

Overview

Journal BMC Health Serv Res

Publisher Biomed Central

Specialty Health Services

Date 2023 Mar 30

PMID 36997918

Authors

Luz Angela Casas

Juliana Alarcon

Alejandra Urbano

Evelyn E Pena-Zarate

Saveria Sangiovanni

Laura Libreros-Pena

Maria Fernanda Escobar

Affiliations

Soon will be listed here.

Abstract

Background: Noncommunicable diseases such as diabetes mellitus (DM) have gained attention worldwide. Latin America experienced a rise in rates of DM. During the COVID-19 pandemic, a telemedicine program was implemented in a quaternary care academic complex in Latin America to continue the follow-up of patients with diabetes.

Objective: The aim of this study is to describe the clinical experience of DM patient management through telemedicine and the HbA1c behavior of patients followed-up through this modality.

Materials And Methods: We conducted a retrospective cohort study including all patients with type 1 or 2 diabetes who were treated via telemedicine from March to December 2020. A Wilcoxon statistical test was used to compare the changes in glycosylated hemoglobin between the first teleconsultation and after 6 months of telemedicine follow-up.

Results: A total of 663 patients were included, 17.65% (117) of whom had type 1 diabetes and 82.35% (546) of whom had type 2 diabetes. Patients with both types of diabetes, presented with stable HbA1c values regardless of the length of follow-up.

Conclusion: The use of telemedicine can be a helpful tool for both patients and health care providers to support the continuity of care to maintain acceptable control levels within glycemic control goals.

References

Rasmussen O, Lauszus F, Loekke M . Telemedicine compared with standard care in type 2 diabetes mellitus: A randomized trial in an outpatient clinic. J Telemed Telecare. 2015; 22(6):363-8. DOI: 10.1177/1357633X15608984. View

. Abridged for Primary Care Providers. Clin Diabetes. 2022; 40(1):10-38. PMC: 8865785. DOI: 10.2337/cd22-as01. View

. 3. Prevention or Delay of Type 2 Diabetes: . Diabetes Care. 2019; 43(Suppl 1):S32-S36. DOI: 10.2337/dc20-S003. View

Mullur R, Hsiao J, Mueller K . Telemedicine in Diabetes Care. Am Fam Physician. 2022; 105(3):281-288. View

. 9. Pharmacologic Approaches to Glycemic Treatment: . Diabetes Care. 2019; 43(Suppl 1):S98-S110. DOI: 10.2337/dc20-S009. View

Lemelin A, Godbout A, Pare G, Bernard S . Improved Glycemic Control Through the Use of a Telehomecare Program in Patients with Diabetes Treated with Insulin. Diabetes Technol Ther. 2019; 22(4):243-248. DOI: 10.1089/dia.2019.0324. View

Jia H, Chuang H, Wu S, Wang X, Chumbler N . Long-term effect of home telehealth services on preventable hospitalization use. J Rehabil Res Dev. 2009; 46(5):557-66. DOI: 10.1682/jrrd.2008.09.0133. View

. 6. Glycemic Targets: . Diabetes Care. 2019; 43(Suppl 1):S66-S76. DOI: 10.2337/dc20-S006. View

Dhediya R, Chadha M, Bhattacharya A, Godbole S, Godbole S . Role of Telemedicine in Diabetes Management. J Diabetes Sci Technol. 2022; 17(3):775-781. PMC: 10210114. DOI: 10.1177/19322968221081133. View

10.

Harding J, Pavkov M, Magliano D, Shaw J, Gregg E . Global trends in diabetes complications: a review of current evidence. Diabetologia. 2018; 62(1):3-16. DOI: 10.1007/s00125-018-4711-2. View

11.

Kusuma C, Aristawidya L, Susanti C, Kautsar A . A review of the effectiveness of telemedicine in glycemic control in diabetes mellitus patients. Medicine (Baltimore). 2022; 101(48):e32028. PMC: 9726301. DOI: 10.1097/MD.0000000000032028. View

12.

. 2. Classification and Diagnosis of Diabetes: . Diabetes Care. 2019; 43(Suppl 1):S14-S31. DOI: 10.2337/dc20-S002. View

13.

De Groot J, Wu D, Flynn D, Robertson D, Grant G, Sun J . Efficacy of telemedicine on glycaemic control in patients with type 2 diabetes: A meta-analysis. World J Diabetes. 2021; 12(2):170-197. PMC: 7839169. DOI: 10.4239/wjd.v12.i2.170. View

14.

Sood A, Watts S, Johnson J, Hirth S, Aron D . Telemedicine consultation for patients with diabetes mellitus: a cluster randomised controlled trial. J Telemed Telecare. 2017; 24(6):385-391. DOI: 10.1177/1357633X17704346. View

15.

ElSayed N, Aleppo G, Aroda V, Bannuru R, Brown F, Bruemmer D . 3. Prevention or Delay of Type 2 Diabetes and Associated Comorbidities: Standards of Care in Diabetes-2023. Diabetes Care. 2022; 46(Suppl 1):S41-S48. PMC: 9810464. DOI: 10.2337/dc23-S003. View

16.

Klonoff D . Telemedicine for Diabetes: Current and Future Trends. J Diabetes Sci Technol. 2015; 10(1):3-5. PMC: 4738230. DOI: 10.1177/1932296815622349. View

17.

Ruiz de Adana M, Alhambra-Exposito M, Munoz-Garach A, Gonzalez-Molero I, Colomo N, Torres-Barea I . Randomized Study to Evaluate the Impact of Telemedicine Care in Patients With Type 1 Diabetes With Multiple Doses of Insulin and Suboptimal HbA in Andalusia (Spain): PLATEDIAN Study. Diabetes Care. 2019; 43(2):337-342. DOI: 10.2337/dc19-0739. View

18.

Fountoulakis S, Papanastasiou L, Gryparis A, Markou A, Piaditis G . Impact and duration effect of telemonitoring on ΗbA1c, BMI and cost in insulin-treated Diabetes Mellitus patients with inadequate glycemic control: A randomized controlled study. Hormones (Athens). 2015; 14(4):632-43. DOI: 10.14310/horm.2002.1603. View

19.

Blandford A, Wesson J, Amalberti R, AlHazme R, Allwihan R . Opportunities and challenges for telehealth within, and beyond, a pandemic. Lancet Glob Health. 2020; 8(11):e1364-e1365. PMC: 7417162. DOI: 10.1016/S2214-109X(20)30362-4. View

20.

Al-Sofiani M, Alyusuf E, Alharthi S, Alguwaihes A, Al-Khalifah R, Alfadda A . Rapid Implementation of a Diabetes Telemedicine Clinic During the Coronavirus Disease 2019 Outbreak: Our Protocol, Experience, and Satisfaction Reports in Saudi Arabia. J Diabetes Sci Technol. 2020; 15(2):329-338. PMC: 7925440. DOI: 10.1177/1932296820947094. View