Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jul;26(6):349-355.
doi: 10.1177/1357633X19828173. Epub 2019 Mar 14.

Home-based video visits for pediatric patients with poorly controlled type 1 diabetes

Stephanie Crossen  1 , Nicole Glaser  1 , Hadley Sauers-Ford  2 , Shelby Chen  2 , Victoria Tran  1 , James Marcin  2
Affiliations

Home-based video visits for pediatric patients with poorly controlled type 1 diabetes

Stephanie Crossen et al. J Telemed Telecare. 2020 Jul.

Abstract

Introduction: Management of type 1 diabetes (T1D) is labor-intensive, requiring multiple daily blood glucose measurements and insulin injections. Patients are seen quarterly by providers, but evidence suggests more frequent contact is beneficial. Current technology allows secure, remote sharing of diabetes data and video-conferencing between providers and patients in their home settings.

Methods: Home-based video visits were provided for six months to pediatric T1D patients with poor glycemic control, indicated by a hemoglobin A1c (HbA1c) ≥8% at enrollment. Video visits were conducted every 4-8 weeks in addition to regularly scheduled clinic visits. Dates of clinic visits and HbA1c values were abstracted from the medical record at baseline and six months. Patients were surveyed at video visits regarding technical issues, and after six months a standardized survey was administered to assess satisfaction with video-based care.

Results: A total of 57 patients enrolled and 36 completed six months of video visits. Patients completing six months averaged 4.0 video visits (SD 1.1). Their frequency of in-person care also increased from 3.2 clinic visits/year at baseline to 3.7 clinic visits/year during the study (P = 0.04). Mean HbA1c reduction among patients completing six months was 0.8% (95% CI 0.2-1.4%); 94% of these patients were "very satisfied" while 6% were "somewhat satisfied" with the experience.

Discussion: This study demonstrates that home-based video visits are feasible and satisfactory for pediatric patients with poorly controlled T1D. Furthermore, use of video visits can improve frequency of subspecialty care and resulting glycemic control in this population.

Keywords: Telemedicine; home telecare; remote consultation.

PubMed Disclaimer

Conflict of interest statement

Declarations: The authors have no conflicts of interest to declare relevant to this research.

Figures

FIGURE 1.
FIGURE 1.
Consort diagram depicting study recruitment
See this image and copyright information in PMC

References

    1. Stanescu DE, Lord K and Lipman TH. The epidemiology of type 1 diabetes in children. Endocrinology and metabolism clinics of North America. 2012; 41: 679–94. - PubMed
    1. Pettitt DJ, Talton J, Dabelea D, et al. Prevalence of diabetes in U.S. youth in 2009: the SEARCH for diabetes in youth study. Diabetes care. 2014; 37: 402–8. - PMC - PubMed
    1. Tuomilehto J The emerging global epidemic of type 1 diabetes. Current diabetes reports. 2013; 13: 795–804. - PubMed
    1. Pihoker C, Forsander G, Wolfsdorf J and Klingensmith GJ. The delivery of ambulatory diabetes care to children and adolescents with diabetes. Pediatric diabetes. 2009; 10 Suppl 12: 58–70. - PubMed
    1. Chiang JL, Kirkman MS, Laffel LM, Peters AL and Type 1 Diabetes Sourcebook A. Type 1 diabetes through the life span: a position statement of the American Diabetes Association. Diabetes care. 2014; 37: 2034–54. - PMC - PubMed

MeSH terms