PDF(Pubmed)
Abstract：
OBJECTIVE: This study aimed to provide a global insight into initiatives in type 1 diabetes care driven by the COVID-19 pandemic and associations with glycemic outcomes.
METHODS: An online questionnaire regarding diabetes care before and during the pandemic was sent to all centers (n = 97, 66,985 youth with type 1 diabetes) active in the SWEET registry. Eighty-two responded, and 70 (42,798 youth with type 1 diabetes) had available data (from individuals with type 1 diabetes duration >3 months, aged ≤21 years) for all 4 years from 2018 to 2021. Statistical models were adjusted, among others, for technology use.
RESULTS: Sixty-five centers provided telemedicine during COVID-19. Among those centers naive to telemedicine before the pandemic (n = 22), four continued only face-to-face visits. Centers that transitioned partially to telemedicine (n = 32) showed a steady increase in HbA1c between 2018 and 2021 (p < 0.001). Those that transitioned mainly to telemedicine (n = 33 %) improved HbA1c in 2021 compared to 2018 (p < 0.001).
CONCLUSIONS: Changes to models of care delivery driven by the pandemic showed significant associations with HbA1c shortly after the pandemic outbreak and 2 years of follow-up. The association appeared independent of the concomitant increase in technology use among youth with type 1 diabetes.
METHODS: An online questionnaire regarding diabetes care before and during the pandemic was sent to all centers (n = 97, 66,985 youth with type 1 diabetes) active in the SWEET registry. Eighty-two responded, and 70 (42,798 youth with type 1 diabetes) had available data (from individuals with type 1 diabetes duration >3 months, aged ≤21 years) for all 4 years from 2018 to 2021. Statistical models were adjusted, among others, for technology use.
RESULTS: Sixty-five centers provided telemedicine during COVID-19. Among those centers naive to telemedicine before the pandemic (n = 22), four continued only face-to-face visits. Centers that transitioned partially to telemedicine (n = 32) showed a steady increase in HbA1c between 2018 and 2021 (p < 0.001). Those that transitioned mainly to telemedicine (n = 33 %) improved HbA1c in 2021 compared to 2018 (p < 0.001).
CONCLUSIONS: Changes to models of care delivery driven by the pandemic showed significant associations with HbA1c shortly after the pandemic outbreak and 2 years of follow-up. The association appeared independent of the concomitant increase in technology use among youth with type 1 diabetes.
摘要：
目的：本研究旨在对由COVID-19大流行驱动的1型糖尿病护理举措及其与血糖结果的关联提供全球见解。
方法：向SWEET登记处活跃的所有中心（n=97,66,985名1型糖尿病青年）发送了关于大流行之前和期间糖尿病护理的在线问卷。八十二人回答，70名(42,798名1型糖尿病青年)有可用数据(来自1型糖尿病病程>3个月的个体，年龄≤21岁)，从2018年到2021年，所有4年。调整了统计模型，其中,用于技术使用。
结果：65个中心在COVID-19期间提供了远程医疗。在大流行前对远程医疗幼稚的中心中(n=22)，四人继续仅面对面访问。部分过渡到远程医疗的中心（n=32）显示，HbA1c在2018年至2021年之间稳步增加（p<0.001）。与2018年相比，2021年主要过渡到远程医疗（n=33％）的HbA1c有所改善（p<0.001）。
结论：在大流行爆发后不久和随访2年后，大流行导致的护理模式的改变与HbA1c显著相关。这种关联似乎与1型糖尿病青年中技术使用的增加无关。
方法：向SWEET登记处活跃的所有中心（n=97,66,985名1型糖尿病青年）发送了关于大流行之前和期间糖尿病护理的在线问卷。八十二人回答，70名(42,798名1型糖尿病青年)有可用数据(来自1型糖尿病病程>3个月的个体，年龄≤21岁)，从2018年到2021年，所有4年。调整了统计模型，其中,用于技术使用。
结果：65个中心在COVID-19期间提供了远程医疗。在大流行前对远程医疗幼稚的中心中(n=22)，四人继续仅面对面访问。部分过渡到远程医疗的中心（n=32）显示，HbA1c在2018年至2021年之间稳步增加（p<0.001）。与2018年相比，2021年主要过渡到远程医疗（n=33％）的HbA1c有所改善（p<0.001）。
结论：在大流行爆发后不久和随访2年后，大流行导致的护理模式的改变与HbA1c显著相关。这种关联似乎与1型糖尿病青年中技术使用的增加无关。
