Delivery of high-quality diabetes care requires a well-informed patient with good self-management skills to work with a knowledgeable and well-staffed specialist team who can advise the patient on how to manage their condition to avoid the (short and long-term) complications of diabetes. During this time of unprecedented pressure on health systems and society, achieving and maintaining optimal blood sugar control can be a real challenge. Patients and their loved ones feel stressed and we know stress can have a deleterious effect on self-care behaviours and on blood sugar control.
Healthcare staff are also feeling stressed and many diabetes team members are being redeployed to the pandemic response. Data from other countries would suggest that diabetes is one of the conditions that carries an increased risk of poor outcome if COVID-19 infection develops.
The purpose of this document is to highlight for frontline staff involved in delivering care to patients with diabetes some issues that may help with achieving good outcomes during the COVID-19 pandemic. This guidance should be used in conjunction and in line with guidance issued from the Health Protection Surveillance Centre (www.hpsc.ie).
The importance of Covid-19 prevention
The advice relating to social distancing, hand hygiene, self-isolation and other measures to prevent the spread of the virus is important for everyone in society but the advice is especially important for people living with diabetes. In the absence of a vaccine or effective anti-viral therapy, avoiding getting the infection is the best form of defence.
Where possible people living with diabetes should avoid attending hospitals, pharmacies and other facilities where their risk of acquiring the infection is increased. Diabetes Centres around the country are delivering ‘Virtual Clinics’ and patients should prepare themselves for these visits as they would a face-to-face outpatient clinic by having an up-to-date record of their blood sugars, uploading any diabetes technology they use and where possible, having recent laboratory results available.
Patients may also want to write down any issues they want to discuss with the doctor or nurse during a virtual clinic consultation.
Impact of the pandemic on diabetes services
All self-management education courses such as Discover Diabetes, DAFNE, DESMOND, CODE, etc. have been postponed due to social distancing regulations, however, online courses are available, free of charge:
Many healthcare professionals working in diabetes teams have been redeployed to the COVID-19 response.
Virtual clinics or telemedicine consultations have replaced outpatient face-to-face clinics.
Diabetic RetinaScreen has suspended all screening clinics until after the pandemic.
Screening for Gestational Diabetes using the OGTT presents problems as pregnant women may not wish to visit the hospital and spend 2-3 hours awaiting a second blood test.
Diabetic Foot Services have been significantly curtailed in some parts of the country due to redeployment of Podiatrists.
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