According to the CDC’s 2020 National Diabetes Statistics Report, approximately 34.2 million Americans—or 1 in 10 adults—have diabetes, and 88 million American adults have prediabetes. With diabetes being a serious complicating comorbidity for coronavirus disease 2019 (COVID-19), managing patients with diabetes during the pandemic has taken on even greater importance, but not without presenting special challenges for health care providers. Members of Physician Performance LLC (PPLLC) in Massachusetts have worked together to care for their patients with diabetes during COVID-19 and have found that the challenges posed by the pandemic have actually created opportunities to care for these patients in new and more effective ways.
PPLLC participating providers Guy A. Navarra, MD, a geriatric and internal medicine physician with Seacoast Medical Associates; pediatric endocrinologist Dr Sanjeev Mehta, MPH, the chief quality officer and interim chief medical officer at the Joslin Diabetes Center; and Dr Saira Naseer, an internal medicine physician with many elderly and diabetic patients, all agree that telemedicine in particular has created marked advantages for caring for patients with diabetes.
The beginning of the pandemic didn’t necessarily look that way, however.
“We had to adapt to a new world, and a new model of how care was delivered,” notes Navarra. At that point, patients had understandably heightened anxiety levels—many “didn’t want to come into the hospital at all. Thank God for telemedicine,” Navarra adds.
Mehta, who galvanized his organization to rethink how they were going to provide care (which was primarily based on face-to-face care prior to the quarantine) notes that while “transitioning from a 99-year-old care model in 48 hours” at the start of the COVID-19 pandemic proved extremely challenging, the results have been more than worth it. Joslin providers can now see patients across the United States and the globe, and telemedicine opened up access to Joslin’s specialty care to patients who live far from health care centers or who could not travel to Joslin.
Telehealth Visits Improve Continuity of Care for Patients With Diabetes
Patients with diabetes often present with a history of health issues and can be a challenging population to treat, especially given the need for multiple visits to a variety of health care specialists and the need to make behavioral changes at home. For instance, physicians did see some understandable weight gain among patients during quarantine—many were not leaving their homes, gyms were closed, and group walking and nutrition programs were on hold. But the more frequent visits that telemedicine allows meant that physicians were able to pick up on this change in activity earlier. Patients also have more consistent access to behavioral health coaching, podiatrists, nutritionists, and other essential tenets of diabetes care.
Navarra agrees: “Continuity of care is especially important in…