Preparedness cycle to address transitions in diabetes care during the COVID-19 pandemic and future outbreaks

• Type of Material: Article
• Authors: Unjali Gujral, Emory University; Leslie Johnson, Emory University; Jannie Nielsen, Emory University; Priyathama Vellanki, Emory University; J. Sonya Haw, Emory University; Georgia Davis, Emory University; Mary Weber, Emory University; Francisco Pasquel, Emory University
• Language: English
• Date: 2020-01-01
• Publisher: BMJ PUBLISHING GROUP
• Publication Version: Final Published Version
• Copyright Statement: © Author(s) (or their employer(s)) 2020.
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1136/bmjdrc-2020-001520
• Title of Journal or Parent Work: BMJ OPEN DIABETES RESEARCH & CARE
• Volume: 8
• Issue: 1
• Grant/Funding Information: This project was supported in part by National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) grant number P30-DK-111024. PV is supported in part by National Institutes of Health (NIH) grant 1K23DK113241. FJP is supported in part by NIH grant 1K23GM128221-01A1.
• Keywords: ADHERENCE; Endocrinology & Metabolism; HYPERGLYCEMIA; MANAGEMENT; diabetes mellitus; diabetes complications; type 2; OUTCOMES; Science & Technology; Life Sciences & Biomedicine; delivery of health care; ORDER PHARMACY USE
• Research Categories: Health Sciences, Nutrition; Health Sciences, Medicine and Surgery; Health Sciences, Health Care Management

Abstract

The COVID-19 pandemic is considered a mass casualty incident of the most severe nature leading to unearthed uncertainties around management, prevention, and care. As of July 2020, more than twelve million people have tested positive for COVID-19 globally and more than 500 000 people have died. Patients with diabetes are among the most severely affected during this pandemic. Healthcare systems have made emergent changes to adapt to this public health crisis, including changes in diabetes care. Adaptations in diabetes care in the hospital (ie, changes in treatment protocols according to clinical status, diabetes technology implementation) and outpatient setting (telemedicine, mail delivery, patient education, risk stratification, monitoring) have been improvised to address this challenge. We describe how to respond to the current public health crisis focused on diabetes care in the USA. We present strategies to address and evaluate transitions in diabetes care occurring in the immediate short-Term (ie, response and mitigation), as well as phases to adapt and enhance diabetes care during the months and years to come while also preparing for future pandemics (ie, recovery, surveillance, and preparedness). Implementing multidimensional frameworks may help identify gaps in care, alleviate initial demands, mitigate potential harms, and improve implementation strategies and outcomes in the future.