Accepted for/Published in: JMIR Diabetes
Date Submitted: Sep 12, 2022
Date Accepted: May 24, 2023
Date Submitted to PubMed: Jun 14, 2023
Glycemic control, renal progression, and usage of telemedicine phone consultations among Japanese type 2 diabetes mellitus patients during the COVID-19 pandemic: a retrospective cohort study
ABSTRACT
Background:
Reduced or delayed medical follow-ups has been reported during the COVID-19 pandemic, which may lead to worsening clinical outcomes for diabetes patients. The Japanese government granted special permission for medical institutions to use telephone consultations and other remote communication modes during the COVID-19 pandemic.
Objective:
We aimed to evaluate changes in the frequency of outpatient consultations, glycemic control, and renal function of type 2 DM patients before and during the COVID-19 pandemic.
Methods:
This is a retrospective single center cohort study in Tokyo, Japan, analyzing results for 3035 patients who visited the hospital regularly. We compared the frequency of outpatient consultations attended (both in person and via telemedicine phone consultation), Glycated Hemoglobin A (HbA1c), and estimated Glomerular Filtration Rate (eGFR) among type 2 DM patients during the six months from April 2020 to September 2020 (during the COVID-19 pandemic) with those during the same period of the previous year, 2019 using Wilcoxon signed rank test. We conducted a multivariate logistic regression analysis to identify factors related to the changes in glycemic control and eGFR. We also compared the changes in HbA1c and eGFR from 2019 to 2020 among telemedicine users and telemedicine non-users using Difference-in-Differences design.
Results:
The number of outpatient consultations attended decreased significantly from 3 (2-3) in 2019 to 2 (2-3) in 2020 (P<.001). Median HbA1c levels deteriorated, though not to a clinically significant degree. The rate of decline in eGFR increased. Changes in HbA1c and eGFR did not differ between patients who utilized telemedicine phone consultations and those who did not.
Conclusions:
The COVID-19 pandemic led to declines in the attendance of outpatient consultations among type 2 DM patients, and these patients also encounter deterioration in kidney function. Difference in consultation modality (in person or by phone) did not affect glycemic control and renal progression of the patients.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.