Diabetes management and COVID-19: ADS advice on teleheath and medications

A/Prof Glynis Ross

Diabetes specialists now have access to telehealth items to consult with some patients without face-to-face contact during the COVID-19 pandemic, the Australian Diabetes Society has advised.

In a communique, the ADS says diabetes health professionals will face problems during the pandemic including lack of staff due to self-isolation requirements, redeployment to other areas, and the potential risk of infection by COVID-19.

“We also acknowledge that there will be changes to delivery of diabetes education in group settings, reduction in face-to-face diabetes care delivery in ambulatory care centres and outpatient clinics,” says ADS president Associate Professor Glynis Ross.

“There will also be changes to settings required for direct contact in situations such as emergency diabetes management, insulin commencement, high risk foot services, diabetes in pregnancy and inpatient diabetes care.”

The ADS says there will be increased reliance on telehealth/telephone access to healthcare services for people with diabetes, and this will be enabled by new MBS items that have been announced by the Department of Health

The temporary MBS and DVA items to allow specialist and consultant physicians to deliver services via telehealth, provided those services are bulk billed.

The telehealth items apply for people already under treatment for chronic health conditions or who are immune compromised. They also apply to vulnerable/isolated patients in specific circumstance  such as being in quarantine or having been diagnosed with COVID-19 virus but not a patient of a hospital

Telehealth consults will also be available for elderly people susceptible to the COVID-19 (over 50 years if ATSI descent), pregnant women and parents of children under 12 months.

“Specialist and consultant physicians who have themselves been isolated because of possible COVID-19 infection can continue to provide certain health services to their patients during the period of the professional’s isolation using these telehealth items,” the ADS statement notes.

The ADS is also supporting a request by the Australian Diabetes Educators to have the telehealth items extended to cover consultation by clinical diabetes educators.

In its communique the ADS also emphasises that patients with diabetes be advised to to have a sick day management plan, “especially for people with type 1 diabetes, including ready access to ketone testing strips. SGLT2 inhibitors

And as per current recommendations, people taking SGLT2 inhibitors should be aware they should discontinue them during intercurrent illness, such as coronavirus infection, to minimise the risk of dehydration and diabetic ketoacidosis.

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