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Diabetes care for the ‘new normal’
Diabetes is a disease that can be difficult to manage. Less than 50 percent of the half a billion people worldwide with diabetes meet glycemic targets, increasing their risk of complications. It’s a situation that cries out for innovation. And strangely enough, it is coming from a surprising source: the pandemic is changing diabetes care…
In fact, because of the restrictions imposed by the pandemic, health care providers have been able to swiftly implement and test models of diabetes care that weren’t possible before…
Making strides in diabetes care
According to a manuscript published in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism, innovation in health care delivery has been jumpstarted by the COVID-19 pandemic.
Health care providers have been testing out innovative models, like telehealth — a visit between a patient and provider conducted over the phone or through videoconference — that have the potential to improve medical outcomes and patient experiences beyond the pandemic.
In 2018, the Endocrine Society formed a task force to study and promote innovative models of care in diabetes. Some of the models reviewed by the task force include telemedicine; eConsultations in which the patient, primary care doctor and endocrinologist participate online together; Project Echo, a global telementoring program; team-based care; pharmacist-led care and the transition from pediatric to adult care.
“We need to change the way we provide care, considering that outcomes of people with diabetes have not improved over the last decade,” says task force chair Dr. Robert A. Gabbay, chief scientific and medical officer of the American Diabetes Association. “Given the dual pandemics of COVID-19 and diabetes, adoption of these innovations has accelerated in the hopes of creating a ‘new normal’ and improvements in the care we provide for people with diabetes.”
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Virtual visits and data collection
Telehealth, in particular, has experienced widespread adoption in recent months and has improved access to diabetes care while supporting necessary physical distancing during the pandemic. According to the Endocrine Society manuscript, evidence shows that telemedicine in diabetes care is comparable in terms of outcomes to traditional office visits.
The availability of connected technologies such as insulin pumps, smart insulin pens and continuous glucose monitors also makes it easier to share patient information virtually. Options for sharing glucose data include newer cloud-based platforms rather than traditional self-reporting of blood sugar logs.
However, it’s important that technological approaches match patient population capabilities. Some patients may have lower Wi-Fi bandwidth or be less technologically savvy, making virtual data reporting more difficult. In these cases, telephone visits can increase access to necessary care.
In addition to telehealth visits, newer models of virtual care delivery are gaining steam, including tele-education, nutrition and psychology. These models may help fill existing gaps in support and collaboration across disciplines in diabetes care.
Tips for optimizing telehealth visits
To get the most out of your telehealth visit for diabetes care, make sure you’re in a quiet place so that you and your doctor can hear each other. If it’s a video call, try signing on a few minutes early so you can check that your device, video and audio are all working properly. Make sure you have good lighting and that your webcam is hitting you at eye level so your doctor can see you.
Have a list of your medications, the dosages and how often you take them. This list should include any over-the-counter medicines, vitamins or other health supplements. Be sure to tell your doctor if there were any changes to your medications, or if you need a refill.
If needed, make sure you have your blood glucose reading log ready for your doctor. Also, if you have the equipment at home, record your vital signs within 24 hours of the telehealth visit. These can include blood pressure, heart rate, temperature and weight.
Before the call, try to write down all the questions you have for your doctor — and keep them handy so you remember to ask them. Also make note of any difficulties you’re having with everyday tasks like cooking, cleaning, walking and using the toilet so you can tell your doctor during the call. Take notes or record your call so you don’t forget your caregiver’s advice.
One more thing… given how much more difficult the pandemic has made everyday life, you may want to ask your doctor about enrolling in a diabetes education program. If the pandemic has changed your access to food or money, or if you’re experiencing added stress and anxiety, your doctor can put you in touch with a program that can help you manage your diabetes through these difficulties.
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Sources:
The path to understanding diabetes starts here — American Diabetes Association
COVID-19 pandemic drives innovation in diabetes care — Endocrine Society
Innovations in Diabetes Care for a Better “New Normal” Beyond COVID-19 — The Journal of Clinical Endocrinology & Metabolism
Tips for a successful telehealth visit — UT Physicians
Find a Diabetes Education Program in Your Area — American Diabetes Association
By Carolyn Gretton
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