Telehealth Monitoring During COVID-19 Could Help Avoid Admissions for Diabetic Ketoacidosis

Acute diabetes complications like diabetic ketoacidosis (DKA) increases morbidity and mortality in addition to adding cost to the health care system. The current COVID-19 pandemic has allowed newer ways to manage high-risk patients with type 1 diabetes (T1D) and DKA through telehealth and may result in lasting benefits to people with T1D. The findings of the study are published in the journal Diabetes Technology & Therapeutics. Entitled "The Silver Lining to COVID-19: Avoiding Diabetic Ketoacidosis Admissions with Telehealth," the article is co-authored by Anne Peters, MD, Keck School of Medicine of the University of Southern California (Los Angeles) and Satish Garg, MD, DTT Editor-in-Chief, University of Colorado Denver (Aurora).

The authors present two case studies of patients with type 1 diabetes who were treated from home using telehealth. The first was a 21-year-old male who had symptoms of COVID-19, was self-quarantining, and had rising blood glucose levels and strongly positive urinary ketones. Shared glucose data through a continuous glucose monitor (CGM) made it possible to make frequent insulin dose adjustments. He was able to recover without the need for physical interaction with the healthcare system.

The second case involved a 26-year-old woman with new-onset type 1 diabetes who was seen on day one briefly in the clinic for diabetes education and to obtain the necessary technology. She had very high glucose levels with ketosis. Ongoing management was via telehealth, and her glucose values improved significantly by day 6. She, too, avoided admission for hyperglycemia associated with diabetic ketosis.

"The COVID-19 pandemic has forced dramatic changes in the delivery of healthcare even in acute situations like diabetic ketoacidosis via telehealth," says DTT Editor-in-Chief Satish Garg, MD, Professor of Medicine and Pediatrics at the University of Colorado Denver (Aurora). "The clinical outcomes are similar without any hospital admissions, thus saving high cost. This was made possible in part by the availability of CGM data through Clarity or the Share feature of the Dexcom G6."

Source-Eurekalert