TELEMEDICINE AND PHYSICAL EXERCISE FOR THE CHILD WITH DIABETES
Authors: Urzeala Constanta , Vlaiculescu Mihaela 
Published: February 2023

This paper is a case study that highlights our concern for increasing the quality of life of the child with diabetes, using telemedicine devices. The central objective is to emphasize the efficiency of the Omnipod wireless insulin pump in the case of a child who, together with the diabetes care team, appropriately manages this metabolic disease and whose treatment also includes physical exercise. Our interest is oriented towards proving the effects derived from the practice of physical exercises on decreasing the amount of insulin administered during the days when the child participates in motor activities, through computerized monitoring.
The research was conducted at the Bucharest DiabNutriMed Clinic of Diabetes, from September to November 2015. As research methods, we used: bibliographic study, observation, case study. Data were collected using the computerized DEXCOM Platinum G4 continuous glucose monitoring devices, the Omnipod wireless insulin pump and their related software programs, and the Diasend platform for downloading the data. We present the case of a child with diabetes who has been using a wireless insulin pump since June 2015. We mention that this child is included in the target group of the project sponsored by Vodafone, "Telemedicine and the insulin-dependent child", obtained by the DiabNutriMed Clinic,which aims to introduce advanced technology, with sensors for continuous glucose monitoring, 24hours a day, which eliminates the need for daily injections to measure the glucose levels.
During our study, the child participated regularly in physical exercise programs, three times a week, outside the school schedule, practicing activities such as swimming and dynamic games.
Information about the child's glucose level and its evolution trend was sent to a web platform and visualized in real time by the family and the diabetes physician, who provided guidance on treatment. According to the indications, the family could remotely administer insulin using the wireless insulin pump with remote control, while the child was carrying out educational and recreational activities uninterruptedly.
It was found that, during the days of participation in motor activities, the amount of insulin decreased, its administration being even suspended when the child showed a tendency towards persistent hypoglycemia, which is impossible to achieve in the insulin therapy administered with an insulin pen, where, once administered, insulin cannot be stopped any more over its entire duration of action, 4 to 6 hours (for rapid insulin). Recording these beneficial effects of physical exercises on the child with diabetes entitles us to state that the Omnipod wireless insulin pump represents not only an instrument for insulin administration, but also a possibility of individualized management adaptable to the activities of the child from minute to minute, which allows him/her free access to various activities. In conclusion, we consider as efficient the use of telemedicine devices for the child with diabetes, because it facilitates a good control of this disease and brings more hope in his life.