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COVID-19大流行前后用于管理儿童和青少年1型糖尿病的远程医疗

Telemedicine for Managing Type 1 Diabetes in Children and Adolescents Before and After the COVID-19 Pandemic.

作者信息

Fogliazza Federica, Sambati Vanessa, Iovane Brunella, Lazzeroni Pietro, Street Maria Elisabeth, Esposito Susanna

机构信息

Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy.

Unit of General Pediatrics and Pediatric Emergency, University Hospital of Parma, 43126 Parma, Italy.

出版信息

J Clin Med. 2024 Dec 3;13(23):7359. doi: 10.3390/jcm13237359.

Abstract

The COVID-19 pandemic has catalyzed the rapid expansion of telemedicine for managing chronic conditions such as type 1 diabetes (T1D) in children and adolescents. This narrative review aims to explore the role of telemedicine in pediatric T1D management by comparing its use before and after the pandemic. We conducted a comprehensive literature review covering studies published between 2000 and 2024, focusing on telemedicine applications in pediatric T1D care. The review includes clinical trials, systematic reviews, and observational studies examining telemedicine's impact on glycemic control, patient satisfaction, and healthcare delivery. Results reveal that telemedicine has enhanced access to care, improved glycated hemoglobin (HbA1c) levels, and reduced diabetic ketoacidosis and hypoglycemic events. Patients and caregivers expressed high satisfaction, especially when using continuous glucose monitoring and insulin pump technologies integrated with telemedicine platforms. However, challenges such as digital literacy gaps, variability in healthcare provider training, and logistical issues like reimbursement policies persist. The pandemic highlighted the potential of telemedicine to supplement traditional in-person care, showing promise in enhancing patient outcomes and reducing healthcare burdens. Further research is needed to optimize telemedicine models for T1D, addressing barriers to implementation and exploring its long-term cost-effectiveness. This review underscores telemedicine's evolving role as a complementary approach in managing pediatric T1D, advocating for the development of standardized care protocols to fully integrate digital health solutions into routine clinical practice.

摘要

新冠疫情促使远程医疗迅速扩展,用于管理儿童和青少年的1型糖尿病(T1D)等慢性病。本叙述性综述旨在通过比较疫情前后远程医疗的使用情况,探讨其在儿科T1D管理中的作用。我们进行了一项全面的文献综述,涵盖2000年至2024年发表的研究,重点关注远程医疗在儿科T1D护理中的应用。该综述包括临床试验、系统评价以及观察性研究,这些研究考察了远程医疗对血糖控制、患者满意度和医疗服务提供的影响。结果显示,远程医疗改善了医疗服务的可及性,降低了糖化血红蛋白(HbA1c)水平,并减少了糖尿病酮症酸中毒和低血糖事件。患者和护理人员表示高度满意,尤其是在使用与远程医疗平台集成的持续葡萄糖监测和胰岛素泵技术时。然而,诸如数字素养差距、医疗服务提供者培训的差异以及报销政策等后勤问题等挑战依然存在。疫情凸显了远程医疗补充传统面对面护理的潜力,在改善患者预后和减轻医疗负担方面展现出前景。需要进一步研究以优化T1D的远程医疗模式,解决实施障碍并探索其长期成本效益。本综述强调了远程医疗作为管理儿科T1D的一种补充方法的不断演变的作用,主张制定标准化护理方案,以便将数字健康解决方案全面整合到常规临床实践中。

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