ESPE Abstracts

Introduction: Telemedicine was adopted during the lockdown due to the COVID-19 pandemic in the follow-up of patients with type 1 diabetes (T1D). Because of its potential to reinforce self-management support outside health care settings it was used still after the lockdown.

Objectives: Longitudinal and observational study aimed to investigate effectiveness of telemedicine in the follow-up of young people with T1D over the 2^nd year by the pandemic spread.

Methods: Data on type and number of annual visits, insulin dose and delivery methods, blood glucose monitoring methods, A1c, AGP, and time spent for physical activity were collected during the routine outpatient visit performed between December 2020 and February 2021 (T1) and were compared with the ones recorded during the same months 2-years after the COVID-19 spread (T2).

Results: Eighty-three children and adolescents with T1D (65% male; median age 14.3 years; T1D duration 7.09 years) were enrolled. Patients were divided into Group A (28 patients; Italian, 85.7% - at least one telemedicine at T2) and Group B (55 patients; Italian 58.2% - none telemedicine at T2). Groups were comparable for number of telemedicine visits at T1 and this data was longitudinally increased in Group A (P=0.013). Physical activity significantly improved in both groups and was comparable at T2. In Group A, rate of insulin pump users increased longitudinally (42.9 vs 53.6%; χ²=18.2; P<0.001). CGM users was 96.4% in both studied periods. In Group B, rate of CGM users increased longitudinally (58.8 vs 61.8%; χ²=64.9; P<0.001). Insulin pump users was 20% in both studied periods. Average of annual HbA1c levels were lower in Group A respect to Group B both at T1 (52.6 vs 65.4 mmol/mol; P<0.0001) and T2 (52.8 vs 63.1 mmol/mol; P<0.0001). HbA1c values were longitudinally unchanged in Group A, while improved in Group B (P=0.015). Rate of HbA1 ≤53 mmol/mol was 53.5% in Group A during both period time; in Group B it was 9.1% at T1 and 10.9% at T2. TIR was significantly higher in Group A respect to Group B both at T1 and T2 (P<0.001).

Conclusions: Our data suggest that telemedicine is effective to maintain a good glycemic control still 2-years after the beginning of the COVID-19 pandemic. We should consider an individual approach for telemedicine use, mainly for patients with a good glycemic control and diabetes technologies users. Next challenge for an easier use of telemedicine should consider to address disparities in access and use.