Health-care providers (HCPs), who can range from family doctors and pharmacists to nurses and dietitians, offer the first line of care for people living with diabetes. Supporting them and the people they serve has become more important than ever with the COVID-19 pandemic, which has resulted in major disruptions in people’s medical care.
One of the key ways Diabetes Canada delivers on its commitment to partner with Canadians to End Diabetes is through resources for HCPs on best practices to care for people with diabetes. Those include professional development sessions and evidence-based clinical tools from Diabetes Canada’s Clinical Practice Guidelines. Early on in the pandemic, Diabetes Canada recognized that frontline clinicians needed more and different types of supports because they couldn’t provide care as usual for their patients.
“One of our first webinars aimed to answer key questions: what is COVID-19 and what do we know about how it affects people with diabetes?” says Joanne Lewis, director, healthcare provider education & engagement, at Diabetes Canada. It was important to provide information about this new infectious disease to help HCPs give their patients the right advice and reassurances.
“It was challenging at the beginning because there was so much we didn’t know,” Ms. Lewis says. “By the time we finished the series, we knew a lot more. We could share some of the research that had been published during that six- to eight-week period on the links between COVID and diabetes.”
Different groups of health-care providers had different knowledge needs, depending on their specific roles in providing care to people with diabetes, she says. “One group was retail pharmacists, whose role quickly expanded. Most people with diabetes weren’t going to see their doctor, but they were still going to their pharmacist to pick up their medications, at that time every month because of new dispensing rules.”
Additional online sessions covered how to provide mental-health supports to patients struggling during the pandemic. For diabetes educators no longer able to meet patients in large group settings, Diabetes Canada developed a two-part online education program they could refer their patients to – to give patients information while they waited to get a one-on-one appointment with the educator.
Other patients could call Diabetes Canada’s information line, 1-800-BANTING, and through the Diabetes Education Line, connect with a professional diabetes educator volunteering to provide advice.
Physicians and other health-care providers were called upon to pivot from in-person to virtual appointments, a significant change that many had little experience with. Online sessions were developed to give providers advice on how to use telehealth and similar technologies and how to use digital diabetes tools such as uploading and remote sharing of data from glucose monitors.
Primary care clinicians need a new approach to delivering diabetes care in the pandemic – one that continues to support evidence-based interventions but does so in a way that balances the risks and benefits of in-person and virtual visits.— Dr. Noah Ivers, Family physician at Women’s College Hospital and a volunteer with Diabetes Canada’s professional section
“We also developed a tool in collaboration with another organization to help family physicians in particular to better understand how to modify their regular diabetes management practices in the midst of COVID-19,” says Ms. Lewis.
Some recommendations in Diabetes Canada’s Clinical Practice Guidelines for treating people with diabetes couldn’t be used in the same way.
"One of the recommendations is that individuals with diabetes should have an A1C test every three months, but labs were either closed or people were afraid to go to labs. Patients due for kidney or eye tests were wondering what to do and were concerned about the impacts of missing key testing.
“We gave physicians advice on what they should modify from the recommendations, including what absolutely still needs to be done and what can wait.”
“Primary care clinicians need a new approach to delivering diabetes care in the pandemic – one that continues to support evidence-based interventions but does so in a way that balances the risks and benefits of in-person and virtual visits,” says Dr. Noah Ivers, family physician at Women’s College Hospital and a volunteer with Diabetes Canada’s professional section.
Seven months on, the demand for special education sessions remains strong. “Our online classes continue to fill up, and we believe we are filling an ongoing gap,” says Ms. Lewis.
“We are pleased that we were able to respond to new needs very quickly, and with so much collaboration and support from our professional community. With 2021 and the 100th anniversary of the discovery of insulin around the corner, we look forward to continuing to partner with health-care professionals to End Diabetes through education and best practices for care.”
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