Telemedicine management of type 2 diabetes mellitus in obese and overweight young and middle-aged patients during COVID-19 outbreak: A single-center, prospective, randomized control study

Wenwen Yin, Yawen Liu, Hao Hu, Jin Sun, Yuanyuan Liu, Zhaoling Wang, Wenwen Yin, Yawen Liu, Hao Hu, Jin Sun, Yuanyuan Liu, Zhaoling Wang

Abstract

Objective: The coronavirus disease-2019 (COVID-19) pandemic severely affected the disease management of patients with chronic illnesses such as type 2 diabetes mellitus (T2DM). This study aimed to assess the effect of telemedicine management of diabetes in obese and overweight young and middle-aged patients with T2DM during the COVID-19 pandemic.

Methods: A single-center randomized control study was conducted in 120 obese or overweight (body mass index [BMI] ≥ 24 kg/m2) young and middle-aged patients (aged 18-55 years) with T2DM. Patients were randomly assigned to the intervention (telemedicine) or control (conventional outpatient clinic appointment) group. After baseline assessment, they were home isolated for 21 days, received diet and exercise guidance, underwent glucose monitoring, and followed up for 6 months. Glucose monitoring and Self-Rating Depression Scale (SDS) scores were evaluated at 22 days and at the end of 3 and 6 months.

Results: Ninety-nine patients completed the 6-month follow-up (intervention group: n = 52; control group: n = 47). On day 22, the fasting blood glucose (FBG) level of the intervention group was lower than that of the control group (p < 0.05), and the control group's SDS increased significantly compared with the baseline value (p < 0.05). At the end of 3 months, glycated hemoglobin (HbA1c) and FBG levels in the intervention group decreased significantly compared with those in the control group (p < 0.01). At the end of 6 months, the intervention group showed a significant decrease in postprandial blood glucose, triglyceride, and low-density lipoprotein cholesterol levels as well as waist-to-hip ratio compared with the control group (p < 0.05); moreover, the intervention group showed lower SDS scores than the baseline value (p < 0.05). Further, the intervention group showed a significant reduction in BMI compared with the control group at the end of 3 and 6 months (p < 0.01).

Conclusion: Telemedicine is a beneficial strategy for achieving remotely supervised blood glucose regulation, weight loss, and depression relief in patients with T2DM.

Trial registration: ClinicalTrials.gov Identifier: NCT04723550.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1. Patient flow diagram.
Fig 1. Patient flow diagram.
Fig 2. Targets of the study.
Fig 2. Targets of the study.
(A-H): Changes in the HbA1c, FBG, PBG, TG, and LDL-C levels as well as SDS, WHR, and BMI over 6 months of the study in the control and intervention groups. HbA1c: glycated hemoglobin, FBG: fasting blood glucose, PBG: postprandial blood glucose, WHR: waist-to-hip ratio, TG: triglyceride, LDL-C: low-density lipoprotein cholesterol, SDS: Self-Rating Depression Scale, BMI: body mass index. “a” indicates p

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