Pontificia Universidad Javeriana, Bogotá, Colombia; Hospital Universitario San Ignacio, Endocrinology Unit, Bogotá, Colombia.
Universidad EAN, Bogotá, Colombia.
Diabetes Metab Syndr. 2021 Jan-Feb;15(1):243-247. doi: 10.1016/j.dsx.2020.12.041. Epub 2021 Jan 5.
In Colombia, the government established mandatory isolation after the first case of COVID-19 was reported. As a diabetes care center specialized in technology, we developed a virtual training program for patients with type 1 diabetes (T1D) who were upgrading to hybrid closed loop (HCL) system. The aim of this study is to describe the efficacy and safety outcomes of the virtual training program.
ology: A prospective observational cohort study was performed, including patients with diagnosis of T1D previously treated with multiple doses of insulin (MDI) or sensor augmented pump therapy (SAP) who were updating to HCL system, from March to July 2020. Virtual training and follow-up were done through the Zoom video conferencing application and Medtronic Carelink System version 3.1 software. CGM data were analyzed to compare the time in range (TIR), time below range (TBR) and glycemic variability, during the first two weeks corresponding to manual mode with the final two weeks of follow-up in automatic mode.
91 patients were included. Mean TIR achieved with manual mode was 77.3 ± 11.3, increasing to 81.6% ± 7.6 (p < 0.001) after two weeks of auto mode use. A significant reduction in TBR <70 mg/dL (2,7% ± 2,28 vs 1,83% ± 1,67, p < 0,001) and in glycemic variability (% coefficient of variation 32.4 vs 29.7, p < 0.001) was evident, independently of baseline therapy.
HCL systems allows T1D patients to improve TIR, TBR and glycemic variability independently of previous treatment. Virtual training can be used during situations that limit the access of patients to follow-up centers.
在哥伦比亚，首例 COVID-19 病例报告后，政府实施了强制性隔离。作为一家专门从事技术的糖尿病护理中心，我们为即将升级到混合闭环（HCL）系统的 1 型糖尿病（T1D）患者开发了一个虚拟培训计划。本研究旨在描述虚拟培训计划的疗效和安全性结果。
一项前瞻性观察队列研究，纳入 2020 年 3 月至 7 月期间诊断为 T1D 的患者，这些患者此前接受过多次胰岛素（MDI）或传感器增强型泵治疗（SAP），现正升级到 HCL 系统。通过 Zoom 视频会议应用程序和 Medtronic Carelink System 版本 3.1 软件进行虚拟培训和随访。分析连续血糖监测（CGM）数据，以比较手动模式的第一、二周和自动模式的最后二周的时间在目标范围内（TIR）、低于目标范围（TBR）和血糖变异性。
共纳入 91 例患者。手动模式的平均 TIR 为 77.3±11.3%，自动模式使用两周后增加至 81.6±7.6%（p<0.001）。TBR<70mg/dL（2.7%±2.28 比 1.83%±1.67，p<0.001）和血糖变异性（%变异系数 32.4 比 29.7，p<0.001）明显降低，与基线治疗无关。
HCL 系统可使 T1D 患者在不依赖于先前治疗的情况下提高 TIR、TBR 和血糖变异性。虚拟培训可在限制患者进入随访中心的情况下使用。
