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Impact of Telemedicine Consultations during the COVID-19 Pandemic on Glycemic Control of Diabetes Patients

COVID-19 Research Area(s): Food & Nutrition, Healthcare Delivery & Policy, Mental Health & Wellbeing

The COVID-19 pandemic has caused drastic lifestyle changes and healthcare delivery challenges. Patients with diabetes are uniquely affected by these changes, as blood sugar control is heavily dependent on lifestyle and access to essential medications and supplies. Many medical clinics were forced to abruptly transition to telehealth to help curb the spread of the COVID-19 pandemic. The purpose of this project is to determine the impact of telehealth consultations in the context of the COVID-19 pandemic on the blood sugar control of patients seen at our clinic.

Due to the COVID-19 pandemic, our endocrinology clinic transitioned to virtual care on March 18, 2020. The literature suggests that self-monitoring of blood glucose paired with telemedicine consultations is an effective strategy for diabetes management, however it is unclear whether telemedicine remains effective in the context of the sudden lifestyle changes caused by the pandemic, including non-essential service closures, travel restrictions, lockdowns, and psychosocial impacts. Patients with diabetes are uniquely affected by these restrictions, as glycemic control is heavily dependent on lifestyle and access to essential medications and supplies. The purpose of this project is to determine the impact of telemedicine consultations in the context of the COVID-19 pandemic on the glycemic control of patients seen at our clinic. A retrospective chart review was performed on 300 type 1 and 2 diabetes patients seen at least once within the 6 months preceding (pre-COVID) and following (post-COVID) March 18, 2020. The primary outcome measure was hemoglobin A1c. For patients with more than 1 A1c value in each time frame, the most recent A1c was used. Demographic information was also collected. There was no significant difference in the pre-COVID and post-COVID A1c values (p=0.40) of the entire sample. There was no significant difference in the pre-COVID and post-COVID A1c values when the sample was stratified by age, diabetes duration, use of CGM, or use of pump. However, there was a significant increase in A1c for females post-COVID (p<0.05). This difference was not observed for males (p=0.22). Our data suggests that telemedicine is an overall effective strategy for optimizing glycemic control of patients with type 1 and type 2 diabetes during the pandemic, with no significant difference in A1c. However, the gender-specific effect of telemedicine consultations during COVID-19 on the glycemic control of females with diabetes indicates a need for further study and intervention.