Fundación Valle del Lili, Departamento de Endocrinología, Cali 760032, Colombia.
Departamento Medicina, Facultad de Ciencias de la Salud, Universidad Icesi, Cali 760031, Colombia.
Int J Environ Res Public Health. 2023 May 4;20(9):5719. doi: 10.3390/ijerph20095719.
Continuous subcutaneous insulin infusion (CSII) has emerged as a potential solution for diabetes management during the pandemic, as it reduces the need for in-person visits and allows for remote monitoring of patients. Telemedicine has also become increasingly important in the management of diabetes during the pandemic, as it allows healthcare providers to provide remote consultations and support. Here, we discuss the implications of this approach for diabetes management beyond the pandemic, including the potential for increased access to care and improved patient outcomes.
We performed a longitudinal observational study between 1 March 2020 and 31 December 2020 to evaluate glycemic parameters in diabetic patients with CSII in a telehealth service. Glycemic parameters were time in range (TIR), time above range, time below range, mean daily glucose, glucose management indicator (GMI), and glycemic variability control.
A total of 36 patients were included in the study, with 29 having type 1 diabetes and 6 having type 2 diabetes. The study found that the proportion of patients achieving target glucose variability and GMI remained unchanged during follow-up. However, in patients with type 2 diabetes, the time in target range increased from 70% to 80%, and the time in hyperglycemia decreased from 2% to 0%.
The results of this study suggest that telemedicine is a strategy for maintaining glycemic control in patients using CSII. However, the lack of access to the internet and adequate telemonitoring devices make it difficult to use on a large scale in emerging countries like ours.
在疫情期间,连续皮下胰岛素输注(CSII)已成为糖尿病管理的一种潜在解决方案,因为它减少了患者的就诊次数,并允许对患者进行远程监测。在疫情期间,远程医疗在糖尿病管理中也变得越来越重要,因为它使医疗保健提供者能够提供远程咨询和支持。在这里,我们讨论了这种方法对大流行后糖尿病管理的影响,包括增加获得护理的机会和改善患者结局的潜力。
我们在 2020 年 3 月 1 日至 12 月 31 日期间进行了一项纵向观察性研究,以评估远程医疗服务中使用 CSII 的糖尿病患者的血糖参数。血糖参数包括时间在目标范围内(TIR)、时间超过目标范围、时间低于目标范围、平均每日血糖、血糖管理指标(GMI)和血糖变异性控制。
共有 36 名患者纳入研究,其中 29 名患有 1 型糖尿病,6 名患有 2 型糖尿病。研究发现,在随访期间,达到目标血糖变异性和 GMI 的患者比例保持不变。然而,在 2 型糖尿病患者中,目标范围内的时间从 70%增加到 80%,高血糖时间从 2%减少到 0%。
这项研究的结果表明,远程医疗是维持使用 CSII 的患者血糖控制的一种策略。然而,由于无法访问互联网和适当的远程监测设备,在像我们这样的新兴国家,很难大规模使用。