COVID-19 大流行期间 2 型糖尿病的远程医疗:一家三级糖尿病中心的经验。

IF 2.5 Q3 ENDOCRINOLOGY & METABOLISM Minerva endocrinology Pub Date : 2024-01-29 DOI:10.23736/S2724-6507.23.04096-4
Silvia Angelino, Paola Caruso, Miriam Longo, Mariluce Barrasso, Filomena Castaldo, Alessandro Pontillo, Stefania Arena, Annarita Palmieri, Giuseppe Bellastella, Maria I Maiorino, Katherine Esposito
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引用次数: 0

摘要

背景:在 COVID-19 大流行期间,远程医疗在很大程度上得到了应用,以保证在面对面就诊急剧减少的时期医疗服务的连续性。本研究的目的是描述一组通过远程访问跟踪的 2 型糖尿病患者的临床特征,并评估 12 个月随访期间血糖代谢控制的变化:这项回顾性观察研究纳入了 136 名年龄大于 18 岁的成人,他们在 2020 年 4 月至 2022 年 3 月期间,在意大利南部的一家糖尿病中心接受了至少三次远程会诊,随访期为 12 个月。在首次就诊(T0)、6 个月后(T1)和 12 个月后(T2)的三个时间点提取了与血糖和血脂概况、治疗、是否存在微血管或大血管并发症以及其他临床特征相关的数据:平均糖尿病病程和 HbA1c 中位值分别为 11.6 年和 7.0%。38名参与者(27.9%)出现了大血管或微血管并发症。随着时间的推移,血糖控制保持稳定,HbA1c(T0 vs. T1 vs. T2,中位数[IQR],7.0 [6.2-7.3],6.6 [6.0-7.5],6.9 [6.2-7.5],P=0.095)和空腹血糖均无明显变化。血脂状况略有改善,但临床变化不大。在随访期间,84 名患者(61.8%)改变了降糖疗法,52 名患者(38.2%)保持不变。在 12 个月的随访期间,没有人出现并发症:通过远程医疗随访的 2 型糖尿病患者都是血糖控制良好的成年人,一般没有慢性并发症,在 12 个月的随访期间,他们的糖尿病控制情况没有恶化。
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Telemedicine for type 2 diabetes during COVID-19 pandemic: experience from a tertiary diabetes center.

Background: Telemedicine was largely employed during COVID-19 pandemic to guarantee continuity of care in a period of dramatic reduction of face-to-face visits. The aim of this study was to describe the clinical characteristics of a cohort of patients with type 2 diabetes followed by tele-visits and to evaluate the changes in the glyco-metabolic control during a 12-month follow-up.

Methods: This retrospective observational study included 136 adults aged >18 years with at least three tele-visits over a 12-month follow-up period, in a Diabetes Center of the Southern Italy, from April 2020 to March 2022. Data related to glycemic and lipid profile, therapy, presence of micro or macrovascular complications, and other clinical features were extracted at three time points, at first visit (T0), after 6 months (T1) and after 12 months (T2).

Results: Mean diabetes duration and median HbA1c values were 11.6 years and 7.0%, respectively. Thirty-eight participants (27.9%) presented macro- or microvascular complications. Glycemic control remained stable over time, without clinically significant changes of HbA1c (T0 vs. T1 vs. T2, median [IQR], 7.0 [6.2-7.3], 6.6 [6.0-7.5], 6.9 [6.2-7.5], P=0.095) and fasting glucose. Lipid profile slightly improved, although without significant clinical change. Glucose lowering therapy was modified in 84 patients (61.8%) and remained unchanged in 52 patients (38.2%) during the follow-up. No participant in the study developed any complications during the 12-month follow-up.

Conclusions: People with type 2 diabetes followed by telemedicine were adults with fair glucose control generally free from chronic complications, whose diabetes control did not worsen during a 12-month follow-up.

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