Kubo Haremaru, Sugimoto Kazuhiro
Diabetes Center, Ohta Nishinouchi Hospital, Koriyama, JPN.
Department of Diabetes and Metabolism, Tohoku University Hospital, Sendai, JPN.
Cureus. 2024 Jan 3;16(1):e51607. doi: 10.7759/cureus.51607. eCollection 2024 Jan.
Type 1 diabetes mellitus (T1D) is an autoimmune-related disease resulting in insulin dependency, treated with insulin injection via pen devices or continuous subcutaneous insulin infusion (CSII). Face-to-face instruction for managing insulin injection and dosing and machine-to-device troubleshooting are required early to initiate CSII from insulin injections. Thus, T1D individuals may encounter significant barriers to pen devices or CSII introduction if they live in remote rural areas. In this regard, intermittently scanned continuous glucose monitoring (isCGM) can share visualized glucose profiles via a cloud-platform-based system, offering the potential as an effective tool in telemedicine. Herewith, we report two cases of subjects with T1D living in remote rural areas whose CSII was safely introduced in outpatient settings with the aid of cloud-platform-based isCGM and a video-meeting tool. They showed improved glucose profiles after CSII initiation. Even under the coronavirus disease 2019 (COVID-19) pandemic, the telemedicine system enabled healthcare providers to monitor glucose profiles and confirm device procedures of CSII. We emphasize the usefulness of online instruction with cloud-platform-based isCGM for introducing CSII in cases with barriers to healthcare access, particularly during the COVID-19 pandemic.
1型糖尿病（T1D）是一种与自身免疫相关的疾病，会导致胰岛素依赖，通过笔式装置注射胰岛素或持续皮下胰岛素输注（CSII）进行治疗。从胰岛素注射开始早期启动CSII时，需要进行面对面的胰岛素注射和给药管理指导以及设备间故障排除指导。因此，如果T1D患者生活在偏远农村地区，他们在引入笔式装置或CSII时可能会遇到重大障碍。在这方面，间歇性扫描式连续血糖监测（isCGM）可以通过基于云平台的系统共享可视化血糖曲线，具有作为远程医疗有效工具的潜力。在此，我们报告两例居住在偏远农村地区的T1D患者，他们在基于云平台的isCGM和视频会议工具的帮助下，在门诊环境中安全地引入了CSII。CSII启动后，他们的血糖曲线得到了改善。即使在2019冠状病毒病（COVID-19）大流行期间，远程医疗系统也使医疗服务提供者能够监测血糖曲线并确认CSII的设备操作流程。我们强调，对于医疗服务获取存在障碍的患者，尤其是在COVID-19大流行期间，基于云平台的isCGM在线指导在引入CSII方面的有用性。
