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2019冠状病毒病大流行期间2型糖尿病的远程医疗:来自一家三级糖尿病中心的经验

Telemedicine for type 2 diabetes during COVID-19 pandemic: experience from a tertiary diabetes center.

作者信息

Angelino Silvia, Caruso Paola, Longo Miriam, Barrasso Mariluce, Castaldo Filomena, Pontillo Alessandro, Arena Stefania, Palmieri Annarita, Bellastella Giuseppe, Maiorino Maria I, Esposito Katherine

机构信息

PhD Program in Traslational Medicine, Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.

Unit of Endocrinology and Metabolic Diseases, University of Campania "Luigi Vanvitelli", Naples, Italy -

出版信息

Minerva Endocrinol (Torino). 2025 Jun;50(2):163-171. doi: 10.23736/S2724-6507.23.04096-4. Epub 2024 Jan 29.

DOI:10.23736/S2724-6507.23.04096-4
PMID:38287789
Abstract

BACKGROUND

Telemedicine was largely employed during COVID-19 pandemic to guarantee continuity of care in a period of dramatic reduction of face-to-face visits. The aim of this study was to describe the clinical characteristics of a cohort of patients with type 2 diabetes followed by tele-visits and to evaluate the changes in the glyco-metabolic control during a 12-month follow-up.

METHODS

This retrospective observational study included 136 adults aged >18 years with at least three tele-visits over a 12-month follow-up period, in a Diabetes Center of the Southern Italy, from April 2020 to March 2022. Data related to glycemic and lipid profile, therapy, presence of micro or macrovascular complications, and other clinical features were extracted at three time points, at first visit (T0), after 6 months (T1) and after 12 months (T2).

RESULTS

Mean diabetes duration and median HbA1c values were 11.6 years and 7.0%, respectively. Thirty-eight participants (27.9%) presented macro- or microvascular complications. Glycemic control remained stable over time, without clinically significant changes of HbA1c (T0 vs. T1 vs. T2, median [IQR], 7.0 [6.2-7.3], 6.6 [6.0-7.5], 6.9 [6.2-7.5], P=0.095) and fasting glucose. Lipid profile slightly improved, although without significant clinical change. Glucose lowering therapy was modified in 84 patients (61.8%) and remained unchanged in 52 patients (38.2%) during the follow-up. No participant in the study developed any complications during the 12-month follow-up.

CONCLUSIONS

People with type 2 diabetes followed by telemedicine were adults with fair glucose control generally free from chronic complications, whose diabetes control did not worsen during a 12-month follow-up.

摘要

背景

在2019冠状病毒病大流行期间,远程医疗被广泛应用,以确保在面对面就诊大幅减少的时期内医疗服务的连续性。本研究的目的是描述一组接受远程就诊的2型糖尿病患者的临床特征,并评估12个月随访期间糖代谢控制的变化。

方法

这项回顾性观察性研究纳入了2020年4月至2022年3月期间在意大利南部一家糖尿病中心接受至少三次远程就诊的136名年龄大于18岁的成年人,随访期为12个月。在三个时间点,即首次就诊时(T0)、6个月后(T1)和12个月后(T2),提取了与血糖和血脂谱、治疗、微血管或大血管并发症的存在以及其他临床特征相关的数据。

结果

糖尿病平均病程和糖化血红蛋白(HbA1c)中位数分别为11.6年和7.0%。38名参与者(27.9%)出现了大血管或微血管并发症。随着时间的推移,血糖控制保持稳定,HbA1c(T0与T1与T2,中位数[四分位间距],7.0[6.2 - 7.3],6.6[6.0 - 7.5],6.9[6.2 - 7.5],P = 0.095)和空腹血糖无临床显著变化。血脂谱略有改善,尽管无显著临床变化。在随访期间,84名患者(61.8%)的降糖治疗方案发生了改变,52名患者(38.2%)保持不变。在12个月的随访期间,研究中没有参与者出现任何并发症。

结论

接受远程医疗的2型糖尿病患者为成年患者,血糖控制尚可,一般无慢性并发症,其糖尿病控制在12个月的随访期间没有恶化。

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