Barbara Davis Center for Diabetes Institution, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
Curr Opin Endocrinol Diabetes Obes. 2022 Aug 1;29(4):397-402. doi: 10.1097/MED.0000000000000745. Epub 2022 Jul 2.
Although telemedicine and telehealth services have been a part of type 1 diabetes (T1D) clinical care for several decades, the expansion of in-home telemedicine during the COVID-19 pandemic significantly increased interest in long-term use as part of routine care. This review highlights the current literature regarding telemedicine in T1D care as well as the benefits and barriers to use in a postpandemic world.
Telemedicine has increased patient contact with healthcare providers, allowing for more frequent insulin dose adjustments and improvements in glycemic outcomes. In addition to routine clinical care, T1D device training and mental healthcare have been successful through telemedicine. Significant barriers to continued telemedicine care exist, including patient access and technology knowledge, language, and loss of face-to-face interaction. Healthcare providers additionally face unpredictable reimbursement and loss of continuity across state lines, and lack of resources and training for device downloads and telemedicine software.
Telemedicine can be successfully used in T1D care and has the potential to significantly impact glycemic and long-term outcomes. Due to continued interest for in-person visits by people with T1D and providers, it is likely that long-term telemedicine use will include a hybrid format.
尽管远程医疗和远程保健服务已经成为 1 型糖尿病(T1D)临床护理的一部分已有几十年,但在 COVID-19 大流行期间,家庭远程医疗的扩展大大增加了人们对其作为常规护理一部分的长期使用的兴趣。这篇综述强调了当前关于 T1D 护理中远程医疗的文献,以及在大流行后世界中使用远程医疗的益处和障碍。
远程医疗增加了患者与医疗保健提供者的接触,使胰岛素剂量调整更加频繁,并改善了血糖控制结果。除了常规临床护理外,通过远程医疗还成功地进行了 T1D 设备培训和心理健康保健。持续的远程医疗护理存在重大障碍,包括患者的获取和技术知识、语言以及面对面互动的丧失。医疗保健提供者还面临不可预测的报销和州际间连续性的丧失,以及设备下载和远程医疗软件方面资源和培训的缺乏。
远程医疗可成功用于 T1D 护理,并有可能对血糖和长期结果产生重大影响。由于 T1D 患者和提供者对面对面就诊的持续兴趣,远程医疗的长期使用很可能将包括混合模式。