Journal of Diabetes Investigation (Aug 2022)

Implementation of diabetes care and educational program via telemedicine in patients with COVID‐19 in home isolation in Thailand: A real‐worldexperience

  • Tasma Harindhanavudhi,
  • Chatvara Areevut,
  • Taninee Sahakitrungruang,
  • Thipaporn Tharavanij,
  • Pongtorn Kietdumrongwong,
  • Orasa Ngimruksa,
  • Patitta Songsiri,
  • Siwadon Pitukweerakul,
  • Nattamon Tanathornkirati,
  • Natthapon Kaewprasert,
  • Ruchirek Thamcharoen,
  • Krittadhee Karndumri,
  • Sunee Saetung,
  • Pimjai Anthanont,
  • Pornpimol Kiattisakthavee,
  • Sarapee Putkong,
  • Phawinpon Chotwanvirat,
  • Chorthip Nartsupha Phattanasri,
  • Srikorn Jinadit,
  • Sira Korpaisarn,
  • Manusvinee Chusane,
  • Rattanapan Samittarucksa,
  • Amornpan Lertrit,
  • Sanguansak Siangruangsang,
  • Kanokporn Sanpawithayakul,
  • Waraporn Sathiravikarn,
  • Sataporn Soisuwan,
  • Parawee Chevaisrakul,
  • Kanokporn Imsakul,
  • Pinradakarn Thuptimtong,
  • Jandanee Sakmanarit,
  • Supaporn Somwang,
  • Hussamon Prasartkaew,
  • Ratanaporn Jerawatana,
  • Siriwan Butadej,
  • Porntip Tachanivate,
  • Wallaya Jongjaroenprasert,
  • Jeeraphan Sripatong,
  • Sunanta Chobtangsilp,
  • Pattraphorn Kamnirdsittiseree,
  • Benjaporn Savetkairop,
  • Warot Manosittisak,
  • Jitra Tantivatanasatien,
  • Amornrat Hathaidechadusadee,
  • Sirimon Reutrakul

DOI
https://doi.org/10.1111/jdi.13804
Journal volume & issue
Vol. 13, no. 8
pp. 1448 – 1457

Abstract

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Abstract Background The coronavirus disease (COVID‐19) outbreak in Bangkok led to a shortage of hospital capacity, and a home isolation system was set up. We described the process of diabetes self‐management education and support (DSMES) and glycemic management via telemedicine, along with outcomes in home‐isolated patients with COVID‐19 infection. Methods A retrospective chart review of glucose values, insulin and corticosteroids use, and outcomes was performed. Results A volunteer group of 21 endocrinologists and 21 diabetes educators/nurses formed the consultation team. Patients with diabetes or at high‐risk of diabetes and receiving corticosteroids were referred by primary volunteer physicians. Glucometers and related supplies, and insulin were donated, and delivered via same‐day delivery services. A chat group of an individual patient/their caregiver, diabetes educator, endocrinologist, and primary physician was formed (majority via LINE® platform) to assess the patient's clinical status and need. Real‐time virtual DSMES sessions were performed and treatments were adjusted via smartphone application or telephone. There were 119 patients (1,398 service days), mean (SD) age 62.0 (13.6) years, 85.7% had a history of type 2 diabetes, and 84.0% received corticosteroids. Insulin was used in 88 patients; 69 of whom were insulin‐naïve. During the first 10 days, there were 2,454 glucose values. The mean glucose level on day 1 was 280.6 (122.3) mg/dL, and declined to 167.7 (43.4) mg/dL on day 10. Hypoglycemia occurred in 1.4% of the values. A majority of patients (79.5%) recovered at home. Conclusion Diabetes care and DSMES delivered via telemedicine to patients on home isolation during COVID‐19 pandemic was safe and effective.

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