Adults with diabetes, health care providers face additional challenges during pandemic
Click Here to Manage Email Alerts
Adults with diabetes continue to navigate diabetes self-management, supply shortages and in-person and telehealth appointments, all while coping with the common challenges of the COVID-19 pandemic, according to two speakers.
“Some of the biggest issues are being able to continue with their self-management of diabetes,” Melissa Young, PharmD, BC-ADM, CDCES, a clinical pharmacist at Veterans Affairs, VISN 19, Rocky Mountain Network, told Healio. “Being able to continue with their activities, their proper nutrition and in some cases getting medications and taking those regularly. Also, regular care, foot care and eye care. Those are indirect harms from the virus or from the pandemic response itself when people are in lockdown.”
Young noted these challenges come on top of the increased risks for people with diabetes — 32% of all people admitted to the ICU in the United States have diabetes, and diabetes is the second most prevalent underlying chronic condition for people with COVID-19 at 30%, she said.
People with diabetes must also cope with all of the other pandemic-related challenges everyone is facing, according to Debra Simmons, MD, MS, professor of medicine at the University of Utah and chief of endocrine section at Salt Lake City Veterans Affairs.
“People with diabetes already have a whole regular life in addition to taking care with their diabetes, so they may be struggling to help other people and their families deal with the pandemic,” Simmons told Healio. “They may have kids they are struggling to do home schooling with. They may be in neighborhoods where they cannot get healthy foods easily. For people who do not have those issues, it can still be difficult because they may have gotten misinformation that they can’t be seen at all.”
In addition, stay-at-home orders can make it difficult for health care providers to keep in touch with patients from a distance. Providers, including diabetes care and education specialists, must actively reach out to people with diabetes instead of waiting to be contacted, especially for those who fall in the highest risk categories, Simmons said.
“As health care providers, we are used to uncertainty and we’re used to change, and we’re used to change happening fairly rapidly,” Simmons said. “But this degree of change and the lack of information in such a small amount of time is hard on health care providers for how to let their patients know what is best for them to do.”
Providers should conduct COVID-19 screening to electronic medical records to look for possible symptoms and exposure. Instructions should be provided to the person if a screening is positive. If a screening is negative, providers should educate the person about the elevated risk for contracting COVID-19.
Telehealth and remote monitoring can decrease physical contact between patients and providers and make monitoring easier when in-person visits are not possible, Young said.
“When we are having our high-risk patients, we are encouraging them to socially distance and any type of uploading they can do with their device certainly does help,” Young said. “It makes visits so much more efficient. Also, it can catch things, bad events before we can catch up with them.”
While remote care may be more common, people with diabetes, especially those who have been unable to leave their homes for months, may have mental health concerns. Simmons said providers must be neutral and recognize some of these mental health concerns are the same many people have during the pandemic. Providers should know where to find behavioral health resources and offer them to anyone who may be interested.
Preventative care remains a concern at this time, Young said. One of the biggest priorities over the next couple of months will be to make sure all people with diabetes have access to the flu vaccine.
“It is vital that we care for our patients globally and also individually,” Young said. “We do what we can to ensure they can continue, in the best way, to perform self-care tasks and make sure that they have access to preventative care to help reduce the risk and prevent against complications.”
Collapse
Simmons D, et al. COVID-19 Update: Protecting Adults with Diabetes. Presented at: Association of Diabetes Care & Education Specialists Annual Meeting; Aug. 13 - 16, 2020; (virtual meeting).
Read more about
Click Here to Manage Email Alerts