Managing new-onset type 1 diabetes during COVID-19 pandemic with tele-diabetes

Reviewed by Emily Henderson, B.Sc.Apr 21 2020

Two new case studies highlight the use of tele-diabetes to manage new-onset type 1 diabetes in an adult and an infant during the COVID-19 pandemic. The article describing these experiences and providing perspectives on the future application of tele-diabetes is published in Diabetes Technology & Therapeutics (DTT), a peer-reviewed journal from Mary Ann Liebert, Inc., publishers.

The article entitled "Managing New-Onset Type 1 Diabetes During COVID-19 Pandemic: Challenges and Opportunities" is coauthored by DTT Editor-in-Chief Satish Garg, University of Colorado (Aurora), David Rodbard, Biomedical Informatics Consultants LLC (Potomac, Maryland), Irl Hirsch, University of Washington (Seattle), and Gregory Forlenza, University of Colorado (Aurora).

The first patient was a 20-year-old who was treated in the hospital for a few days and then managed virtually. He was treated with multiple daily injections of insulin and a continuous glucose monitor, with data upload to his caregivers to facilitate virtual management of his diabetes. The physician adjusted his insulin dose every day. His initial time-in-range (TIR) was 16%, which improved to 58% after 2 weeks of virtual management, and at 3 weeks the TIR was at 90%.

The second patient was a 12-month-old who was started on an insulin pump and a continuous glucose monitor. The family was taught how to upload the insulin pump data via their home computer, using a software account linked to the hospital. The continuous glucose monitor was set up on a cell phone worn by the child on a fanny pack, with remote monitoring by both the parents and continuous connectivity to software linked to the hospital account. The physician made daily dose adjustments via phone or email based on the data received.

The COVID-19 pandemic has forced many providers to look for alternative approaches to manage high-risk patients with new-onset type 1 diabetes through Telehealth, especially by employing new technologies like Dexcom G6 CGM and Clarity App. Since many of the long-standing regulations were removed during this pandemic along with similar reimbursements for Tele-visits, Telehealth, or Virtual patient visits, these have become a popular method of delivering care for both new-onset patients with type 1 diabetes and for established patients, with similar or even better outcomes."

DTT Editor-in-Chief Satish Garg, MD, Professor of Medicine and Pediatrics at the University of Colorado Denver (Aurora)