Abstract
The coronavirus disease (COVID-19) pandemic has presented unique challenges for people with diabetes, in addition to their high-risk stratification for infection. Supporting people with diabetes to self-care has been critical to reduce their risk of severe infection. This global pandemic has presented an opportunity to digitalize diabetes care and rapidly implement virtual diabetes clinics, with the aim of optimizing diabetes management and well-being, while keeping patients safe. We performed a rapid review of the literature to evaluate the feasibility and effectiveness of virtual clinics in diabetes care before and during the COVID-19 pandemic and have combined these findings with our own reflections in practice. We identified examples demonstrating safety and feasibility of virtual diabetes clinics, which aligns with our own clinical experience during the pandemic. The advantages of virtual clinics include reduced treatment burden, improved therapeutic alliances, societal and psychological benefits, and in our experience, innovative solutions to overcome the challenges presented by the transition from in-person to virtual care. We have provided three infographics to illustrate lessons learned and key recommendations, including steps to establish a virtual diabetes clinic, a checklist guide for health care professionals conducting virtual clinics, and a patient guide for making the most out of the virtual clinic. It is important to continue adapting to this pandemic and to make technology a sustainable option for the future of diabetes care.
Highlights
We are in the midst of the coronavirus disease (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which has resulted in thousands of deaths worldwide [1,2]
A small Italian study showed that for people with type 1 diabetes who were not working during the pandemic and using continuous glucose monitoring, their time in range significantly improved from 54% to 65%, and this was attributed to decreased hyperglycemia [11]
Technical barriers would be expected when setting up virtual consultations; we have shared a checklist that we developed for setting up a virtual clinic (Figure 1)
Summary
We are in the midst of the coronavirus disease (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which has resulted in thousands of deaths worldwide [1,2]. From our clinic team experience of using virtual consultations with people with diabetes, it is evident that some patients feel comfortable showing the HCP their house environment and exercise regimen, and introduce them to their family members, within professional boundaries This offers a unique insight into environmental or interpersonal factors, which may influence the self-care activities of people with diabetes. 5 (page number not for citation purposes) lessons we have learned include: (a) the importance of integrating multiple members of the MDT into the one virtual consultation; (b) avoiding the checklist approach and instead focusing on an individualized, person-centered consultation; (c) and acknowledging that video consultation may be preferred to telephone because of the additional benefits of human contact, body language, and the opportunity to gain better insight into the lifestyle and livelihood of people with diabetes in order to tailor medical support . We aim to prepare our patients to attend virtual consultations, by creating a safe environment and respecting their safety (Figure 3), but to create a digital platform that would integrate within the current NHS system
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