Clinicians highlight transformation of adult diabetes service during COVID-19

Clinicians at UHS are marking Diabetes Awareness Week (8 to 12 June) by highlighting how they have transformed diabetes services during COVID-19.

Developments included the rollout of a seven-day service, participation on the national response group and a new support group on Twitter for patients nationwide.

“This has been a worrying time for those living with diabetes, especially in light of headlines in the news that focus on the increased risk of having diabetes and contracting COVID-19,” said Philip Newland-Jones, consultant pharmacist and diabetes service lead (pictured right).

“It is important to understand that there are risk factors that cannot be changed, such as sex, age, ethnicity, but there are risk factors such as glucose levels and weight that we are able to and have been supporting patients with.”

The added complexity of the effects of COVID-19 on diabetes control has meant many patients have required multiple reviews. The inpatient team made 482 individual patient reviews in April and 568 individual reviews in May for a total of 433 patients with diabetes admitted to UHS, while the team also collaborated with community partners to ensure seven-day support in the community for those discharged over a weekend.

“We moved to working seven days a week during the period of time with the highest number of patients being admitted when it was clear that patients with diabetes were more likely to be hospitalised with COVID-19,” Philip explained.

“Our service continued to review patients referred to us by doctors, nurses and pharmacists across the hospital ensuring that patients had access to the diabetes expertise they might require and we worked to ensure medication safety remained paramount for people on insulin and for those prescribed medicines that would be unsafe if admitted unwell with COVID-19.”

He added: “In addition, Dr Mayank Patel, consultant diabetologist, and I were invited by the national inpatient diabetes lead, Professor Gerry Rayman, to join a national multi-disciplinary professional diabetes COVID response group representing all four nations. In collaboration with Diabetes UK and NHS England, this group has produced national guideline documents to help clinical teams who are managing patients with diabetes during the pandemic. Being members of this group has ensured the guidance was rapidly implemented at UHS.”

The UHS diabetes service has also worked hard to continue to offer needed support to patients beyond the traditional outpatient clinic based approach.

Philip said: “We have begun to utilise telephone and video clinics within the diabetes service to help reduce the risk to those who previously would have needed to come physically to a hospital clinic, while we are working to find suitable alternative clinic sites for face-to-face clinics to take place where it is necessary for good clinical care.

“We are also working with NHS Southampton Clinical Commissioning Group and the Solent Community Diabetes Service to further support those living with diabetes at higher risk, such as those with type 1 diabetes, higher BMI and higher glucose levels, to ensure we do everything we can to reduce further health risks.”

As a further extension of support for patients in Southampton but also across the UK and globally, Philip helped run a national support group on Twitter called @Diabetes101.

“Running this account has delivered a great deal of psychological support for those living with diabetes and translated complex information about risk factors into clear information for people to understand their own risk and what they can do about it,” Philip said.

“The content to date has been viewed four million times from all around the world and patient feedback about the support offered has been outstanding.”