Challenges of diabetes management during the
            <scp>COVID</scp>
            ‐19 pandemic

Scott, Emma; Jenkins, Alicia J.; Fulcher, Gregory

doi:10.5694/mja2.50665

Cited by 41 publications

(39 citation statements)

References 14 publications

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“…Disruptions in the provision of care, dilemmas between receiving it and strict self-isolation, fear of the clinical consequences of delayed care, anxiety, and possibly feeling left alone in trying to cope, were most likely shared experiences with many other ill and vulnerable people, in many countries around the world during the pandemic. In fact, similar risks posed by the pandemic and by the clinical response have been noted for several other diseases, including other neurodegenerative conditions, 26 diabetes 27 and cancer. 28 Health systems' responses to COVID-19 have often been dictated by emergency conditions.…”

Section: Discussionmentioning

confidence: 57%

Impact of the COVID-19 pandemic on persons with multiple sclerosis: Early findings from a survey on disruptions in care and self-reported outcomes

Manacorda

Bandiera

Terzuoli

et al. 2020

J Health Serv Res Policy

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Objective To describe the disruptions in care experienced by persons with Multiple Sclerosis in Italy due to the COVID-19 pandemic and the self-reported impact on their health and wellbeing. Methods A cross-sectional online survey was completed by 2722 persons with Multiple Sclerosis, after Italy instituted a national lockdown in response to the pandemic. Results Persons with Multiple Sclerosis reported that the pandemic caused broad disruptions to usual health and social care services, which impacted on their health and wellbeing. Disruptions in care were consistently associated with negative self-reported impacts on the expected progression of the disease, on out-of-pocket expenditure and on carer’s stress. Psychological consequences were associated with interruption to usual psychological support, and concerns about the safety of care delivered in person. Conclusions The quality of life of persons with Multiple Sclerosis depends greatly on prompt access to a broad range of health and care services. Negative psychological impacts reported by persons with Multiple Sclerosis with less severe disabilities show that accessible integrated services are crucial for maintenance of their wellbeing. Most persons with Multiple Sclerosis with more severe disability experienced negative impacts on perceived health. Their carers compensating for lack of social input resulted in care overburden. As continuity of care is crucial for persons with Multiple Sclerosis, as well as for persons with chronic conditions in general, strategies must be in place to ensure it is included in future pandemic response plans.

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Section: Discussionmentioning

confidence: 57%

Impact of the COVID-19 pandemic on persons with multiple sclerosis: Early findings from a survey on disruptions in care and self-reported outcomes

Manacorda

Bandiera

Terzuoli

et al. 2020

J Health Serv Res Policy

View full text Add to dashboard Cite

show abstract

“…The restriction of consultations in specialized outpatient clinics has led to an increase in the incidence of emergencies with decompensated diabetes, including ketoacidosis, which requires a differential diagnosis with acute surgical abdomen. Given on the one hand the long duration of the restrictive measures imposed by the pandemic, but also the fact that diabetes is considered a risk factor for severe evolution in SARS-CoV-2 infection, efforts should be made to further educate people with diabetes regarding the management of their condition, including the use of tele-medicine if possible, educational programs and strategies to ensure medication and glucose testing availability and affordability (47,48).…”

Section: Sars-cov 2 Infection-a Novel Cause Of Differential Diagnosismentioning

confidence: 99%

Acute surgical abdomen during the COVID‑19 pandemic: Clinical and therapeutic challenges

et al. 2021

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The present study investigated the effects of the COVID-19 pandemic on the clinical presentation and therapeutic management of acute surgical abdomen. A retrospective study of emergency hospitalizations with a diagnosis of acute surgical abdomen between April and July 2020 vs. a similar period in 2019 was performed. The observation sheets and the operating protocols were analyzed. Between April and July 2020, 50 cases of acute surgical abdomen were hospitalized and treated, compared to 43 cases in the same period last year. The main types of pathology in both groups included: Occlusions (60%, respectively 44.2% in 2019) and peritonitis (32%, respectively 41.8% in 2019). There was an increased rate of patients with colorectal cancers neglected therapeutically or uninvestigated, who presented during the pandemic period with emergencies for complications such as occlusion or tumor perforation (32 vs. 6.97%, P=0.0039). One case, with gastric perforation, was COVID-positive, with no pulmonary symptoms at admission. The number of postoperative infectious complications was lower during the pandemic (2 vs. 13.95%, P=0.0461). As the COVID-19 pandemic appears to be still far from ending, we should learn to adapt our surgical protocols to the new evidence.Oncological patients are a vulnerable group, who were neglected in the first months of the pandemic. SARS-Cov-2 infection may be a cause of abdominal pain and should be taken into account in different diagnoses of acute abdomen in surgical wards. Correct wearing of adequate personal protective equipment (PPE) and respecting strict rules of asepsis and antisepsis are required for preventing in-hospital transmission of infection.

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“…It is clear that people with diabetes are at greater risk of serious health impacts in pandemics such as COVID-19 than people without diabetes [13,14]. As highlighted, effective management of blood glucose in people with diabetes and COVID-19 will lead to better outcomes and lower mortality rates [15,16]. Whether the resources that were developed and measures that have been implemented had a positive effect on the health outcomes for people with diabetes is not yet known.…”

Section: Discussionmentioning

confidence: 99%

The Australian response to the COVID-19 pandemic and diabetes – Lessons learned

Andrikopoulos

Johnson

2020

Diabetes Research and Clinical Practice

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The COVID-19 pandemic has had a significant impact on the economy and health system of most countries in the world and this is also true of Australia. Australia has not seen the huge surge of COVID-19 positive cases and subsequent hospitalisations and deaths experienced in other parts of the world. However there have been important social and health strategies to ''flatten" the curve, to reduce infections and to manage those infected. These have included closure of international and interstate borders, local lockdown measures, physical distancing, shift to work from home, closure of non-essential businesses and full or partial closure of all schools and tertiary education facilities. From the diabetes care perspective, there was a significant and concerted diversion of hospital resources and staff to COVID-19 specific activities. Reduced access to primary care, diagnostic and hospital services for diabetes, combined with fear of exposure to the virus in these settings, led to a significant drop in access to usual diabetes care. Provision of outpatient and private sector diabetes services via telehealth was encouraged and supported by expanded and new government subsidies. Importantly, for the first time, there was government funded subsidy for care delivered via the telephone and inclusion of credentialled diabetes educators in funded telephone/telehealth support. The Australian health professional and consumer organisations worked cooperatively producing guidelines, position statements and other educational resources specific for the COVID-19 setting. Once the COVID-19 pandemic is over, review of all the changes will be important, determining which should be permanently implemented. The learnings from COVID-19 should help prepare Australia for future pandemics or other major health crises.

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Challenges of diabetes management during the COVID ‐19 pandemic

Cited by 41 publications

References 14 publications

Impact of the COVID-19 pandemic on persons with multiple sclerosis: Early findings from a survey on disruptions in care and self-reported outcomes

Impact of the COVID-19 pandemic on persons with multiple sclerosis: Early findings from a survey on disruptions in care and self-reported outcomes

Acute surgical abdomen during the COVID‑19 pandemic: Clinical and therapeutic challenges

The Australian response to the COVID-19 pandemic and diabetes – Lessons learned

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