Mean CGM Values Before and During COVID-19 Pandemic Demonstrate Noninferiority of Telehealth in Pediatric T1D

Kaushal, Tara Tinsley Liane J.; Volkening, Lisa K.; Turcotte, Christine Laffel Lori M.

Aim: The COVID-19 pandemic called for rapid deployment of telehealth. To assess utility of telehealth in pediatric T1D, we compared CGM glucose values in youth with T1D using CGM before and during the pandemic. Methods: The EHR provided visit frequency and CGM metrics. Data during pandemic (3/16/20 to 10/29/20) were compared with data from the same calendar months in 2019. Youth (N=469) using CGM and seen in both periods were included based on pre-pandemic characteristics: age 1-18 yr, T1D duration ≥6 mo (if age <6) or ≥1 yr (if age ≥6 yr). CGM metrics included mean and SD glucose, coefficient of variation (CV), and glucose management index (GMI). Each youth's CGM data were averaged in each time period and compared in paired analyses. Results: Youth (46% male) had a mean age 12.4±3.5 yr, T1D duration 6.1±3.6 yr, HbA1c 7.8±0.9%;80% were pump-treated. Pre-pandemic, 0.1% of visits were telehealth, increasing to 99.6% during pandemic. Mean number of visits during each 7-mo period increased from 2.5 in 2019 to 2.7 in 2020 (p=.006). CGM metrics generally improved during the pandemic period (Table). Those whose visit frequency increased with telehealth had the greatest improvement in CGM glucose, from 192±72 to 183±67 (p<.001). Conclusions: Telehealth allowed increased visit frequency and improved CGM glucose metrics, supporting non-inferiority and potential benefit of telehealth for youth with T1D using CGM.