Is remote insulin pump training safe for youths with T1D?

Remote insulin pump training among young patients with type 1 diabetes (T1D) appears to be as safe as in-person training, suggest the results of a recent study.

“[R]emote training could be an alternative method to promote health equity by increasing access to diabetes technology for youth with T1D in whom in-person training may be a challenge,” the investigators said.

Insulin pump training was usually conducted in-house with the patient and families in attendance prior to the COVID-19 pandemic, but the lockdown made it challenging for in-person education. Thus, the investigators introduced virtual trainings for new insulin pump initiations.

In this study, the feasibility and effectiveness of remote and in-person trainings were evaluated in the years 2020 and 2021. The investigators compared the age, sex, race, glycaemic control at 5 months after insulin pump initiation, incidence of severe hypoglycaemic episodes, and diabetic ketoacidosis (DKA) between the two training models.

Of the 118 insulin pump trainings initiated during the study period, 73 (62 percent) were in-person (mean age 10.6 years, 67 percent male, 55 percent White) and 39 (33 percent) were remote (mean age 11.6 years, 49 percent male, 67 percent White).

No cases of severe hypoglycaemia requiring a third-party assistance, hospitalizations, or DKA in the first 6 months following insulin pump start occurred in either group. After adjusting for baseline A1c and body mass index percentile group, the number of patients with optimal glycaemic control (A1c ≤7 percent) at 6 months postpump initiation was similar between the two training groups (p=0.35).

“A larger study is warranted to further evaluate the safety and effectiveness of this alternative method,” the investigators said.