Did the COVID-19 pandemic stimulate telemedicine in pediatric diabetes care in Germany? A multicenter analysis of the year 2020 in the DPV-registry.

Abstract

Abstract Objectives: We analyzed uptake, volume and covariates of telemedicine use in children and adolescents with type 1 diabetes in 2020 with focus on the COVID-19 lockdown in Germany and provide first outcome data associated with telemedicine use. Research design and methods: Based on data from the German Diabetes Prospective Follow-up Registry (DPV) in 2020, we included 247 pediatric diabetes centers following 26,365 children and adolescents with type 1 diabetes. Centers and individuals were characterized according to telemedicine use. Effects of the lockdown from March 13th to May 13th 2020 versus the entire years 2020 and 2019 were analyzed.Results: During the lockdown in 2020, telemedicine visits increased from pre-lockdown 0.6% of all patient visits to 12.8% and remained 3.5 % until end of 2020. Among 247 centers only 11 provided telemedicine to more than 50 patients, while telephone contacts were the preferred telemedicine-mode during lockdown. Patients receiving telemedicine in 2020 had lower HbA1c, longer distance to diabetes centers, less frequently migration background and higher use of insulin pumps or CGMS. Discussion: Telemedicine experienced a dramatic boost during and after the strict lockdown in Germany. Anyhow absolute numbers of telemedicine in outpatient contacts remained below 5% and thus telemedicine did not take a load-carrying role in pediatric diabetes care in Germany. Having migration background and not using diabetes technology possibly reflect barriers to scale up digital communication.