TY - JOUR

T1 - Preparedness cycle to address transitions in diabetes care during the COVID-19 pandemic and future outbreaks

AU - Gujral, Unjali P

AU - Johnson, Leslie

AU - Nielsen, Jannie

AU - Vellanki, Priyathama

AU - Haw, J Sonya

AU - Davis, Georgia M

AU - Weber, Mary Beth

AU - Pasquel, Francisco J

N1 - © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2020/7

Y1 - 2020/7

N2 - 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.

AB - 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.

KW - Betacoronavirus/isolation & purification

KW - COVID-19

KW - Coronavirus Infections/epidemiology

KW - Delivery of Health Care/standards

KW - Diabetes Mellitus/therapy

KW - Disease Outbreaks/prevention & control

KW - Humans

KW - Infection Control/organization & administration

KW - Pandemics/prevention & control

KW - Pneumonia, Viral/epidemiology

KW - Public Health

KW - SARS-CoV-2

KW - Telemedicine/methods

U2 - 10.1136/bmjdrc-2020-001520

DO - 10.1136/bmjdrc-2020-001520

M3 - Journal article

C2 - 32690631

VL - 8

JO - B M J Open Diabetes Research & Care

JF - B M J Open Diabetes Research & Care

SN - 2052-4897

IS - 1

ER -