Implementation of diabetes care and educational program via telemedicine in patients with COVID-19 in home isolation in Thailand: A real-worldexperience.

BACKGROUND: The coronavirus disease (COVID-19) outbreak in Bangkok led to a shortage of hospital capacity, and a home isolation system was set up. We described the process of diabetes self-management education and support (DSMES) and glycemic management via telemedicine, along with outcomes in home-isolated patients with COVID-19 infection. METHODS: A retrospective chart review of glucose values, insulin and corticosteroids use, and outcomes was performed. RESULTS: A volunteer group of 21 endocrinologists and 21 diabetes educators/nurses formed the consultation team. Patients with diabetes or at high-risk of diabetes and receiving corticosteroids were referred by primary volunteer physicians. Glucometers and related supplies, and insulin were donated, and delivered via same-day delivery services. A chat group of an individual patient/their caregiver, diabetes educator, endocrinologist, and primary physician was formed (majority via LINE® platform) to assess the patient's clinical status and need. Real-time virtual DSMES sessions were performed and treatments were adjusted via smartphone application or telephone. There were 119 patients (1,398 service days), mean (SD) age 62.0 (13.6) years, 85.7% had a history of type 2 diabetes, and 84.0% received corticosteroids. Insulin was used in 88 patients; 69 of whom were insulin-naïve. During the first 10 days, there were 2,454 glucose values. The mean glucose level on day 1 was 280.6 (122.3) mg/dL, and declined to 167.7 (43.4) mg/dL on day 10. Hypoglycemia occurred in 1.4% of the values. A majority of patients (79.5%) recovered at home. CONCLUSION: Diabetes care and DSMES delivered via telemedicine to patients on home isolation during COVID-19 pandemic was safe and effective.

The comparative study of diabetic specific formula and standard formula on postprandial plasma glucose control in type 2 DM patients.

OBJECTIVE: To compare the postprandial plasma glucose level after diabetic specific formula (DSF) and standard formula (SF) administration in type 2 diabetic patients. MATERIAL AND METHOD: Thirty type 2 diabetic patients were included in the present randomized, controlled, double-blind, cross-over study. Subjects received DSF and isocaloric SF as a bolus administration of 400 mL while continuing their anti-diabetic medications. Venous blood samples were collected and analyzed to assess plasma glucose levels at pre- and at 30, 60, 90, 120, and 180 min post-administration of the formulas. RESULTS: Postprandial glucose profiles were significantly lower with DSF compared to SF administration determined as a mean glucose concentration at 2-hour post-administration. The glucose area under the curve (AUC) after DSF consumption was 33% lower than the AUC after SF consumption, p < 0.001. CONCLUSION: Use of DSF resulted in a significantly lower postprandial rise in plasma glucose concentrations than using SF. It should be the preferred option in diabetic patients who need nutritional support.