About this item:

101 Views | 52 Downloads

Author Notes:

Dr Francisco J Pasquel; fpasque@emory.edu

UPG, LJ, and FJP conceptualized the article and designed Figure 1. UPG and FJP wrote the first draft of the manuscript. JN and MBW wrote and edited sections of the manuscript. PV, JSH, and GMD critically reviewed the approach and edited successive drafts. FJP created the concept and designed the approaches for the framework. All authors approved the final version.

PV has received consulting fees from Merck and Boehringer Ingelheim. FJP has received unrestricted research support from Merck and Dexcom and consulting fees from Merck, Boehringer Ingelheim, Sanofi, Lilly, and AstraZeneca.


Research Funding:

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.


  • Science & Technology
  • Life Sciences & Biomedicine
  • Endocrinology & Metabolism
  • diabetes mellitus
  • type 2
  • diabetes complications
  • delivery of health care

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


Journal Title:



Volume 8, Number 1


Type of Work:

Article | Final Publisher PDF


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.

Copyright information:

© Author(s) (or their employer(s)) 2020.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/).
Export to EndNote