Use of Telemedicine in Adults with Type 1 Diabetes: Do Age and Use of Diabetes-Related Technology Matter?
- 1 September 2023
- journal article
- research article
- Published by Mary Ann Liebert Inc in Telemedicine and e-Health
- Vol. 29 (9), 1374-1382
- https://doi.org/10.1089/tmj.2022.0397
Abstract
Objective:Older adults are generally less proficient in technology use compared with younger adults. Data on telemedicine use during the COVID-19 pandemic in older persons with type 1 diabetes (T1D) and the association of telemedicine with the use of diabetes-related technology are limited. We evaluated care delivery to older adults compared with younger adults with T1D in a prepandemic and pandemic period. Methods:Data from electronic health records were evaluated for visit types (in-person, phone, and video) from two sequential 12-month intervals: prepandemic (April 2019–March 2020) and pandemic (April 2020–March 2021). Results:Data from 2,832 unique adults with T1D were evaluated in two age cohorts: younger (40–64 years) and older (≥65 years). Half of each group used continuous glucose monitoring (CGM), whereas 54% of the younger and 37% of the older cohort used pump therapy (p < 0.001). During the pandemic compared with the prepandemic period, visit frequency increased in both the younger (0.65 vs. 0.76 visits/patient/quarter; p < 0.01) and older (0.72 vs. 0.80 visits/patient/quarter; p < 0.01) cohorts. During the pandemic, older adults used more phone visits compared with younger adults (48% vs. 32%; p = 0.001). Patients using either pump therapy or CGM were more likely to use video visits compared with phone visits in both younger (41% vs. 24%; p < 0.001) and older cohorts (53% vs. 42%; p < 0.001). Conclusions:Adults using diabetes-related technologies, independent of age, accessed more video visits than those not using devices. Telemedicine visits appeared to maintain continuity of care for younger and older adults with T1D, supporting the future of a hybrid-care model.Keywords
This publication has 25 references indexed in Scilit:
- Effect of Continuous Glucose Monitoring on Glycemic Control in Adolescents and Young Adults With Type 1 DiabetesJAMA, 2020
- State of Type 1 Diabetes Management and Outcomes from the T1D Exchange in 2016–2018Diabetes Technology & Therapeutics, 2019
- Telemedicine Cost–Effectiveness for Diabetes Management: A Systematic ReviewDiabetes Technology & Therapeutics, 2018
- Type 1 Diabetes Self-Management From Emerging Adulthood Through Older AdulthoodDiabetes Care, 2018
- Telemedicine in the Management of Type 1 DiabetesPreventing Chronic Disease, 2018
- Teleconsultation in type 1 diabetes mellitus (TELEDIABE)Acta Diabetologica, 2017
- 11. Older Adults:Standards of Medical Care in Diabetes—2018Diabetes Care, 2017
- Continuous Glucose Monitoring in Older Adults With Type 1 and Type 2 Diabetes Using Multiple Daily Injections of Insulin: Results From the DIAMOND TrialJournal of Diabetes Science and Technology, 2017
- Risk Factors Associated With Severe Hypoglycemia in Older Adults With Type 1 DiabetesDiabetes Care, 2015
- Severe Hypoglycemia and Diabetic Ketoacidosis in Adults With Type 1 Diabetes: Results From the T1D Exchange Clinic RegistryJournal of Clinical Endocrinology & Metabolism, 2013