Use of telemedicine to evaluate the adherence of treatment of patients with type 1 diabetes in context in the context of COVID-19 Lima - Peru

ABSTRACT

Introduction: During COVID19 Dm1 patients without receiving medical assistance, in this context, the use of telemedicine became necessary to maintain continuity of treatment and to cope with the situation. Objective: To evaluate the utility of telemedicine in the adherence of the treatment of patients with DM1 in Peru, during COVID19. Method: A prospective study was conducted in 25 patients with DM1 in the context of COVID19. The patients came from hospitals, and private clinics in Lima Peru. Patients received clinical evaluation by a pediatric endocrinologist through the zoom platform, messages by wsp weekly with parental consent. Monitoring of blood glucose levels, HbA1c,insulin regimens, carbohydrate control, and warning signs during COVID19 was evaluated. Results: there were 17 girls and 8 boys, an average age of 12 years, an average debut age of 9 years, an average time of illness of 4 years and the average insulin dose was 1UI/kg/day. The average HbA1c was 7.45%. 36% had proteinuria. Before the start of the intervention, the mean of glycemic controls was 4 v/day, achieving that 90% reach an average of 6v/day glycemic controls at the cut of the data analysis. 8% had poor metabolic control despite follow-up, we observed changes in attitudes and control of the disease by COVID19,Mental health issues were addressed in the context of a pandemic, as part of the comprehensive package provided. Due to COVID19, not all the patients included in the study had HbA1c values subsequent to controls and telemedicine follow-up. 20% of the patients were carbohydrate-free and 76% of the patients had suboptimal glycemic control. Conclusion: From the teleconsultation strategy, better adherence to treatment was obtained, achieving 90% had glycemic control at an average of 6v/day. The patients presented greater commitment to disease management despite the limitations of COVID19. Telemedicine has proven to be a useful intervention to improve adherence and metabolic control of with DM1 patients.