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Impact of the COVID-19 pandemic on management of children and adolescents with Type 1 diabetes.
Choudhary, Abha; Adhikari, Soumya; White, Perrin C.
  • Choudhary A; Division of Pediatric Endocrinology, Department of Pediatrics, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX, 75390-9063, USA. abha.choudhary@utsouthwestern.edu.
  • Adhikari S; Division of Pediatric Endocrinology, Department of Pediatrics, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX, 75390-9063, USA.
  • White PC; Division of Pediatric Endocrinology, Department of Pediatrics, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX, 75390-9063, USA.
BMC Pediatr ; 22(1): 124, 2022 03 10.
Article in English | MEDLINE | ID: covidwho-1736357
ABSTRACT

BACKGROUND:

The coronavirus disease-2019 (COVID-19) pandemic had widespread impacts on the lives of parents and children. We determined how the pandemic affected Type 1 diabetes patients at a large urban pediatric teaching hospital.

METHODS:

We compared patient characteristics, glycemic control, PHQ-9 depression screen, in person and virtual outpatient encounters, hospitalizations and continuous glucose monitor (CGM) utilization in approximately 1600 patients in 1 year periods preceding and following the local imposition of COVID-related restrictions on 3/15/2020 ("2019" and "2020" groups, respectively).

RESULTS:

In a generalized linear model, increasing age, non-commercial insurance, Black and Hispanic race/ethnicity, and non-utilization of CGMs were all associated with higher hemoglobin A1c (HbA1c), but there was no difference between the 2019 and 2020 groups. The time in range in CGM users was lower with non-commercial insurance and in Black and Hispanic patients; it improved slightly from 2019 to 2020. CGM utilization by patients with non-commercial insurance (93% of such patients were in government programs, 7% uninsured or "other") increased markedly. In 2020, patients with commercial insurance (i.e., private-pay or provided by an employer) had fewer office visits, but insurance status did not influence utilization of the virtual visit platform. There was no change in hospitalization frequency from 2019 to 2020 in either commercially or non-commercially insured patients, but patients with non-commercial insurance were hospitalized at markedly higher frequencies in both years. PHQ-9 scores were unchanged.

CONCLUSIONS:

Hospitalization frequency, glycemic control and depression screening were unchanged in our large urban pediatric teaching hospital during the COVID pandemic. Increased utilization of CGM and rapid adoption of telemedicine may have ameliorated the impact of the pandemic on disease management.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Diabetes Mellitus, Type 1 / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Adolescent / Child / Humans Language: English Journal: BMC Pediatr Journal subject: Pediatrics Year: 2022 Document Type: Article Affiliation country: S12887-022-03189-2

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Diabetes Mellitus, Type 1 / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Adolescent / Child / Humans Language: English Journal: BMC Pediatr Journal subject: Pediatrics Year: 2022 Document Type: Article Affiliation country: S12887-022-03189-2