Children with type 1 diabetes in four Latin American countries were more likely to see a doctor if they had access to telemedicine during the coronavirus pandemic, according to a new study published in the journal Diabetes Technology & Therapeutics.
Telemedicine — using video chatting or even a phone call to have a virtual appointment with a health care professional — has long been seen as a useful option for people who live in rural or remote areas, both in the United States and around the world . But this benefit is only possible if people in these areas have the means to connect for a virtual visit, such as reliable internet access and a tablet or phone. And people in at least some remote areas may be less likely to be able to access telemedicine, even though they potentially stand to benefit the most from this service.
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For the latest study, researchers looked at the number of medical visits (virtual or in-person) as well as the number of A1C tests (a measure of long-term blood glucose control) among 227 children with diabetes during the COVID-19 pandemic in 2020, compared with previous years, based on records from pediatric diabetes clinics in Argentina, Chile, Peru, and Ecuador. Like the United States, these countries saw an expansion of telemedicine being offered by health care providers during the pandemic, as noted in a Healio article on the study. To be included in the study, children had to be under 18 years old in 2020, to have had type 1 diabetes since at least 2017, and to have attended at least one medical visit in 2018 and in 2020 (virtually or in-person).
Access to telemedicine increased number of health care visits
The average age of the study participants was 12.7 years. Out of these 227 children, 145 had access to telemedicine during the pandemic in 2020. Most received multiple daily insulin injections, while 6.6% used an insulin pump. The researchers found that children with telemedicine access had more visits, on average, than those without access in 2020 — 6.9 visits, compared with only 2.6 visits. This stands in stark contrast to what was seen in 2018 and 2019, when there was no difference in the average number of visits between these groups. What’s more, children without telemedicine access had fewer visits, on average, in 2020 compared with the previous two years — the average numbers of visits was 5.1 in 2018 and 5.5 in 2019 for this group.
Among children with telemedicine access, only 2.1% had no record of an A1C test in 2020, compared with 32.9% of children without telemedicine access. The average number of A1C tests taken in 2020 was 1.79 for children with telemedicine access, compared with 0.99 for those without access. For those without telemedicine access, this represents a drop from an average of 2.01 tests in 2018 and 1.89 tests in 2019.
The researchers concluded that telemedicine is a valuable service for children with diabetes, and may even encourage people to access services that require a lab visit, like an A1C test. More research is needed to find out how access to telemedicine affects care for children with diabetes in different situations, including in different countries, in different geographic regions within the United States, and in different income categories and racial or ethnic groups.
Want to learn more about raising a child with type 1 diabetes? Read “The Type 1 Diabetes Diagnosis” and “Type 1 Diabetes at School: What Personnel Need to Know.”
