Nationwide digital/virtual diabetes care of children, adolescents and young adults with type 1 diabetes during a COVID-19 pandemic in Slovenia

Abstract

Background: During coronavirus pandemic disease 2019 (COVID-19) the Government of the Republic of Slovenia introduced a series of restrictive measures including outpatient clinics closure and a cessation of all elective healthcare visits. To sustain attentiveness to optimal diabetes care provision, the vast majority of appointments for individuals with type 1 diabetes were transitioned to video digital/virtual visits. Methods: In this prospective observational study, we compared glycaemic control of children, adolescents and young adults with type 1 diabetes from the Slovenian National Childhood Type 1 Diabetes Registry during the pre-lockdown and lockdown periods. We approached all individuals with type 1 diabetes, who had a visit scheduled between 15th of March and 20th of May 2020. Results: Out of 326 subjects, 313 (96% response rate) attended a video digital/virtual visit. Glycaemic control was not impaired during the lockdown period in individuals with type 1 diabetes and has even slightly improved. Mean glucose was 9.3 mmol/l (IQR 8.3–10.3) during the lockdown, compared to 9.5 mmol/l (IQR 8.2–10.9), p = 0.001 during the pre-lockdown period. Conclusion: In a short period of time, we established effective workflows to enable video digital/virtual visits that provided individuals with type 1 diabetes good clinical support and prevented deterioration of this chronic condition and its acute complications during the COVID-19 pandemic.

Keywords

• type 1 diabetes
• glycemic control
• telemedicine
• children and adolescents