Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 6 de 6
Filter
Add filters

Language
Document Type
Year range
1.
Journal of Clinical Outcomes Management ; 29(5):185-192, 2022.
Article in English | EMBASE | ID: covidwho-2090913

ABSTRACT

There have been remarkable innovations in diabetes management since the start of the COVID-19 pandemic, but these groundbreaking innovations are drawing limited focus as the field focuses on the adverse impact of the pandemic on patients with diabetes. This article reviews select population health innovations in diabetes management that have become available over the past 2 years of the COVID-19 pandemic from the perspective of the T1D Exchange Quality Improvement Collaborative, a learning health network that focuses on improving care and outcomes for individuals with type 1 diabetes (T1D). Such innovations include expanded telemedicine access, collection of real-world data, machine learning and artificial intelligence, and new diabetes medications and devices. In addition, multiple innovative studies have been undertaken to explore contributors to health inequities in diabetes, and advocacy efforts for specific populations have been successful. Looking to the future, work is required to explore additional health equity successes that do not further exacerbate inequities and to look for additional innovative ways to engage people with T1D in their health care through conversations on social determinants of health and societal structures. Copyright © 2022 Turner White Communications Inc.. All rights reserved.

2.
Journal of Clinical Outcomes Management ; 29(1):27-31, 2022.
Article in English | EMBASE | ID: covidwho-1884742

ABSTRACT

Background: Patient outcomes of COVID-19 have improved throughout the pandemic. However, because it is not known whether outcomes of COVID-19 in the type 1 diabetes (T1D) population improved over time, we investigated differences in COVID-19 outcomes for patients with T1D in the United States. Methods: We analyzed data collected via a registry of patients with T1D and COVID-19 from 56 sites between April 2020 and January 2021. We grouped cases into first surge (April 9, 2020, to July 31, 2020, n = 188) and late surge (August 1, 2020, to January 31, 2021, n = 410), and then compared outcomes between both groups using descriptive statistics and logistic regression models. Results: Adverse outcomes were more frequent during the first surge, including diabetic ketoacidosis (32% vs 15%, P< .001), severe hypoglycemia (4% vs 1%, P= .04), and hospitalization (52% vs 22%, P< .001). Patients in the first surge were older (28 [SD,18.8] years vs 18.0 [SD, 11.1] years, P< .001), had higher median hemoglobin A1c levels (9.3 [interquartile range {IQR}, 4.0] vs 8.4 (IQR, 2.8), P< .001), and were more likely to use public insurance (107 [57%] vs 154 [38%], P< .001). The odds of hospitalization for adults in the first surge were 5 times higher compared to the late surge (odds ratio, 5.01;95% CI, 2.11-12.63). Conclusion: Patients with T1D who presented with COVID-19 during the first surge had a higher proportion of adverse outcomes than those who presented in a later surge.

3.
Pediatric Diabetes ; 22(SUPPL 30):35-36, 2021.
Article in English | EMBASE | ID: covidwho-1571032

ABSTRACT

Introduction: Health insurance coverage type differs significantly by socio-economic status and racial groups in the United States. There is limited data on the association between insurance and the risk of adverse outcomes for patients with pre-existing T1D and COVID19. Objectives: The aim of this study was to determine if publicly insured pediatric and adolescent patients with Type 1 Diabetes (T1D) were more likely to experience adverse outcomes compared to privately insured patients with acute COVID-19 infections. Methods: Data from 575 patients with previously established T1D aged <24 years with acute COVID-19 infections was analyzed from the T1DX-COVID-19 Surveillance Registry. Data for the registry was collected from 52 endocrinology clinics across the U.S, using an online survey tool. Each site completed the survey using electronic medical record (EMR) data between April 2020 and May 2021. Results: Privately insured patients were more likely to identify as Non-Hispanic White than publicly insured patients (63% vs 18%, p<0.001). T1D patients with COVID-19 that were on public insurance reported higher A1c (9.5% vs 7.9%, p<0.001), lower insulin pump use (29% vs 62%, p<0.001), as well as lower continuous glucose monitor (CGM) use (51% vs 77%, p<0.001) compared to privately insurance patients. Publicly insured patients with T1D and COVID-19 were three times more likely to be hospitalized than privately insured patients (Odds Ratio 3.4, 95% Confidence Interval: 2.1-5.4). Conclusions: Our data reveals a high rate of hospitalization and DKA among children and adolescents with T1D and COVID19 with public health insurance despite controlling for other potential confounders. This underscores that those on public health insurance are more vulnerable to adverse health outcomes during the COVID19 pandemic. (Table Presented).

4.
Pediatric Diabetes ; 22(SUPPL 29):84, 2021.
Article in English | EMBASE | ID: covidwho-1228821

ABSTRACT

Introduction: While there is rapidly emerging information describing race or ethnicity outcome disparities of patients hospitalized with COVID-19, no such data is available for people with type 1 diabetes (T1D). Objectives: This U.S. based, multi-center surveillance study aimed to investigate racial disparities among presenting symptoms, and adverse outcomes of patients with T1D who tested positive for SARS CoV-2 (N = 26) or are suspected to have COVID-19. As a secondary objective, this study also reports differences in access to SARS CoV-2 testing by racial group (Non-Hispanic White versus Minority) by analyzing data among T1D patients with COVID-like symptoms (N = 24) who were unable to get tested. Methods: De-identified patient data was collected through T1D Exchange's Type 1 Diabetes-COVID-19 Registry. Patient information for people who tested positive for SARS CoV-2, and patients suspected to have COVID-19 were reported by healthcare providers from U.S. Endocrinology clinics. Racial groups were classified as Non- Hispanic White (NH White) or minority (all other races). Results: We analyzed 50 patients with T1D, of which 25 (50%) were reported NH White, 10 (20.0%) Hispanic, 10 (20.0%) Non-Hispanic Black, 1 (2%) Asian, and 2 (4.0%) other. The mean age of the NH White population was 19.2 years (SD = 12.25, Range = 6.0-61.0), and 44% were female. Among the NH White population (N = 25), the reported highest level of care at the time of reporting was ICU at 16.6%, compared to 26.1% of the minority population (N = 23). Of the NH White population, 60% were tested for SARS CoV-2, compared to 36% of the minority population. The most prevalent adverse T1D outcome was diabetic ketoacidosis in both NH White (16.67%) and minority (34.78%) populations. Two patient deaths were recorded, one with confirmed COVID-19, both of Hispanic origin. Conclusions: This study provides racial differences in clinical outcomes of patients with T1D with confirmed or suspected COVID-19 in the United States.

5.
Pediatric Diabetes ; 22(SUPPL 29):83-84, 2021.
Article in English | EMBASE | ID: covidwho-1228814

ABSTRACT

Introduction: While there is rapidly emerging information describing characteristics of patients hospitalized with confirmed COVID-19, no such data is available for people with type 1 diabetes (T1D). Objective: This U.S. based, multi-center surveillance study aimed to investigate characteristics, presenting symptoms, and adverse outcomes of patients with T1D who tested positive for SARS CoV-2 (N = 26). As a secondary objective, this study also reports patient attributes and clinical outcomes among T1D patients with COVID-like symptoms (N = 24) who tested negative or were unable to get tested. Methods: De-identified patient data was collected through T1D Exchange's Type 1 Diabetes-COVID-19 Registry. Patient information for people who tested positive for SARS CoV-2, as well as patients suspected to have COVID-19 were reported by healthcare providers from Endocrinology clinics at participating sites in the US. Statistical analysis was completed using SAS Studio software (version 3.8). Results: We analyzed 50 patients with T1D, of which 26 tested positive for SARS CoV-2 by nasopharyngeal sample PCR, and 24 were reported to have COVID-19-like symptoms but no positive test. In the group that tested positive for SARS CoV-2 (N = 26), mean age was 25.5 years (SD = 17.98, range = 7.0-79.0, IQR = 14.0-28.0), 61.5% (16 of 26) were female, and 38.46% (10 of 26) were Non- Hispanic White. Among T1D patients who tested positive for SARS CoV-2, the most prevalent adverse type 1 diabetes outcome was diabetic ketoacidosis (42.3%). The highest level of care at the time of reporting was hospitalization (23.1% [6 of 26]) or ICU ((30.8% [8 of 26]) in this population. One patient with confirmed with COVID-19 and one patient with a suspected case (4.1%) died. Conclusions: This study provides patient characteristics and clinical outcomes of patients with type 1 diabetes who had either confirmed or suspected COVID-19 in the United States.

6.
Journal of Clinical Outcomes Management ; 27(6):256-259, 2020.
Article in English | Scopus | ID: covidwho-1143829
SELECTION OF CITATIONS
SEARCH DETAIL