Muthukrishnan J, Venugopal Nirmala, Basavaraj A P, Bagga Garvit, Jayakrishnan V Y, Bharadwaj Khushboo, Thoke Santosh V
Consultant (Medicine) & Endocrinologist, Base Hospital, Delhi Cantt, India.
Classified Specialist (Medicine), Base Hospital, Delhi Cantt, India.
Med J Armed Forces India. 2021 Jul;77(Suppl 2):S393-S397. doi: 10.1016/j.mjafi.2021.04.001. Epub 2021 Jul 26.
Patients with type 1 diabetes mellitus (DM) require intensive monitoring, which was adversely affected during coronavirus disease 2019 (COVID-19) restrictions.
We evaluated the management of type 1 DM and the role of telephonic consultation and follow-up in 46 patients (10 on insulin pump) with type 1 DM at our centre from 1 February 2020 to 31 January 2021. Patients were telephonically counselled fortnightly. Web-based diabetes education sessions for the patients and parents were conducted. Finally, change in HbA1c during the period of the study, frequency of severe hypoglycaemia, hospital admissions for hyperglycaemic emergencies and degree of satisfaction with care rendered by the treating team were assessed by ratings scored by the patients.
Five episodes of severe hypoglycaemia were noted in three patients. Two patients had diabetic ketoacidosis. Patients on insulin pump showed a mean baseline HbA1c of 7.8%. Nine of these patients (90%) showed an improvement in Hba1c during the study period compared to 64.3% of patients on conventional regimen. There were no episodes of severe hypoglycaemia or hospitalization with DKA noted in these patients. Only two patients had COVID-19 disease with mild manifestations. Overall satisfaction levels with therapy were high.
This study illustrates the role played by teleconsultation and video conferencing during the period of the COVID-19 pandemic in ensuring optimal healthcare delivery to patients with type 1 DM. Some of these methods can be used even after the pandemic to improve patient convenience and reduce the out-patient burden on the hospitals.
1型糖尿病患者需要强化监测，而在2019冠状病毒病（COVID-19）限制措施实施期间，这受到了不利影响。
我们评估了2020年2月1日至2021年1月31日期间，本中心46例1型糖尿病患者（10例使用胰岛素泵）的1型糖尿病管理情况以及电话咨询和随访的作用。每两周对患者进行一次电话咨询。为患者及其家长举办了基于网络的糖尿病教育课程。最后，通过患者评分评估研究期间糖化血红蛋白（HbA1c）的变化、严重低血糖的发生频率、高血糖急症的住院情况以及患者对治疗团队提供护理的满意度。
3例患者出现5次严重低血糖发作。2例患者发生糖尿病酮症酸中毒。使用胰岛素泵的患者平均基线HbA1c为7.8%。与接受传统治疗方案的患者中64.3%的改善率相比，这些患者中有9例（90%）在研究期间HbA1c有所改善。这些患者中未出现严重低血糖发作或糖尿病酮症酸中毒住院情况。只有2例患者患有COVID-19且症状轻微。总体治疗满意度较高。
本研究说明了在COVID-19大流行期间，远程会诊和视频会议在确保为1型糖尿病患者提供最佳医疗服务方面所发挥的作用。即使在大流行之后，其中一些方法也可用于提高患者便利性并减轻医院门诊负担。
