Implementation of Video Consultations Within a Personalized Hybrid Care Model for Children and Adolescents with Type 1 Diabetes Using Automated Insulin Delivery Systems: A Real-World Descriptive Study

Background: Telemedicine complements traditional healthcare delivery and may improve access, continuity of care, and patient engagement, particularly in chronic conditions requiring regular follow-up. Video consultation is a widely adopted telemedicine modality and is increasingly integrated into hybrid care models. Methods: This real-world implementation project describes scheduled video consultations embedded in a hybrid care model for children and adolescents with type 1 diabetes using continuous glucose monitoring (CGM) and integrated insulin delivery technologies as part of routine clinical care. A total of 38 families were offered video consultations as part of routine care; 18 adopted the hybrid model. Video consultations were used for routine follow-up, shared review of device data, treatment adjustment, and diabetes education. Family experience was assessed using a voluntary 5-point Likert-scale satisfaction questionnaire. Complete longitudinal CGM data were available for 13 participants, all of whom were established users of the same automated insulin delivery (AID) platform (MiniMed™ 780G (Medtronic MiniMed, Inc. Minneapolis, MN, USA) integrated with Guardian™ 4 (Medtronic MiniMed, Inc. Minneapolis, MN, USA) continuous glucose monitoring). Results: Between 2022 and 2024, 162 video consultations were conducted. Acceptability was high, with 95% (17/18) of respondents reporting high satisfaction (score ≥ 4 on the 5-point Likert scale). 89% (16/18) of families perceived the quality of care as comparable to face-to-face visits for routine follow-up. Families highlighted convenience, reduced travel burden, and flexibility, as well as the value of shared review of CGM and AID system data. Group-level CGM-derived metrics appeared descriptively similar across sequential face-to-face visits and video consultations. Individual patient trajectories showed expected variability but no consistent pattern of deterioration during periods of remote follow-up. Conclusions: Video consultation is a feasible and well-accepted complementary modality within hybrid care models for pediatric type 1 diabetes. When integrated with CGM and automated insulin delivery systems, it supports personalized, data-driven clinical decision-making and continuity of care. Structured implementation and systematic evaluation are essential for sustainable integration into routine practice.