Nwosu Benjamin Udoka, Pellizzari Margaret, Pavlovic Maia N, Ciron Jason, Talib Rashida, Sohail Rubab
Division of Endocrinology, Department of Pediatrics, Cohen Children's Medical Center, Hempstead, NY, United States.
Department of Pediatrics, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Queens, NY, United States.
Front Clin Diabetes Healthc. 2024 Apr 30;5:1362627. doi: 10.3389/fcdhc.2024.1362627. eCollection 2024.
There is no head-to-head comparison of the safety and efficacy of virtual versus in-office insulin pump initiation for youth with type 1 diabetes in the US. The study's aim was to determine the safety and efficacy of virtual versus in-office pump initiation in pediatric type 1 diabetes.
A longitudinal retrospective study of 112 subjects: 65% (n=73), ages 11.2 ± 3.8 years(y), received in-office training; and 35% (n=39), ages 12.0 ± 4.0y, received virtual training. The number of White subjects was 40 (55%) in the in-office group, and 25 (66%) in the remote group; while Black subjects were 11 (15%) in the in-office group and 4 (10%) in the virtual group. Data were collected at pump initiation, 3 and 6 months.
There were no significant differences in sex, race, height, weight, BMI, and the duration of diabetes between the groups at baseline. There was no significant difference in A1c between the groups at 0, 3, and 6 months. A1c correlated significantly with the glucose management indicator at 0, 3, and 6 months: baseline: r=0.49, p<0.0001; 3 months: r=0.77, p<0.0001; and 6 months: r=0.71, p<0.0001. There was no relationship between A1c or TIR and pubertal status, BMI, sex, or race. A1c was significantly elevated in the non-White individuals at 6 months only: 57.9 mmol/mol (50.8-69.4) versus 51.9 mmol/mol (46.5-59.6)], p=0.007.
Virtual insulin pump initiation is safe and effective in children with type 1 diabetes. This approach could accelerate the adoption of the use of diabetes technology in minority populations in the US.
在美国，对于1型糖尿病青少年患者，尚未有关于虚拟方式与门诊启动胰岛素泵治疗的安全性和有效性的直接比较研究。本研究旨在确定在儿童1型糖尿病患者中，虚拟方式与门诊启动胰岛素泵治疗的安全性和有效性。
对112名受试者进行纵向回顾性研究：65%（n = 73），年龄11.2±3.8岁，接受门诊培训；35%（n = 39），年龄12.0±4.0岁，接受虚拟培训。门诊组白人受试者40名（55%），远程组25名（66%）；门诊组黑人受试者11名（15%），虚拟组4名（10%）。在启动胰岛素泵时、3个月和6个月收集数据。
两组在基线时的性别、种族、身高、体重、BMI和糖尿病病程无显著差异。在0、3和6个月时，两组的糖化血红蛋白（A1c）无显著差异。在0、3和6个月时，A1c与血糖管理指标显著相关：基线时：r = 0.49，p<0.0001；3个月时：r = 0.77，p<0.0001；6个月时：r = 0.71，p<0.0001。A1c或血糖目标范围内时间（TIR）与青春期状态、BMI、性别或种族之间无关联。仅在6个月时，非白人个体的A1c显著升高：57.9 mmol/mol（50.8 - 69.4）对比51.9 mmol/mol（46.5 - 59.6）]，p = 0.007。
对于1型糖尿病儿童，虚拟方式启动胰岛素泵是安全有效的。这种方法可以加速美国少数族裔人群对糖尿病技术的采用。
