Don’t let COVID-19 defer the diabetes care you need

As COVID-19 cases continue rising across the country, it’s important for Canadians to listen to public health officials and defer non-essential outings, avoid closed and crowded spaces and wear a mask or face covering. But one thing should not be postponed: A visit with your family doctor.

World Diabetes Day tomorrow is a reminder that visiting family doctors is essential for diabetes patients. Good diabetes care can prolong life and prevent complications like heart attacks, stroke, blindness and amputation for the one in 10 Canadians it affects.

Now more than ever, good diabetes care requires partnership with patients. Healthcare teams across the country are adapting the ways we provide care so that visits can continue despite the pandemic. Most diabetes visits can be “virtual” – usually by phone, sometimes by video, email or secure messaging. No longer do patients need to take time to look presentable, commute to their doctor’s office and sit in the waiting room to be seen.

Here are some ways to ensure diabetes patients get the care they need:

Regular appointments: We suggest people with diabetes continue to have appointments with their healthcare team every three to six months. These appointments are crucial for preventing diabetes complications and most can be done virtually.

Measuring blood pressure: During an office visit, doctors usually check weight and blood pressure. But these are things people with diabetes can do reliably at home, ideally just before their virtual appointment. Don’t have a blood pressure machine? Hypertension Canada has some great resources on recommended machines and how to use them. A doctor’s note may help you cover the cost of the machine.

Checking feet: During an office visit, doctors also usually check a patient’s feet for loss of feeling, one risk factor for developing foot ulcers. It turns out that checking feet is actually pretty easy to do at home using a simple “touch the toes” test. If at any time you notice something concerning, your doctor can take a closer look though photos or videos.

Delaying routine blood tests: People with diabetes usually have blood tests every three to six months. But we need to balance the benefit of these tests with the risk of COVID-19 exposure when visiting a clinic. If things are stable, your doctor may suggest delaying routine blood tests to every six to nine months and/or using a glucometer to gauge your sugar control.

Maintaining healthy life choices: Exercise, healthy eating and sugar control are key to staying healthy with diabetes. A diabetes educator can offer practical tips and guidance. People with diabetes can connect with a diabetes educator free of charge through Diabetes Canada at 1-800 BANTING (1-800-226-8464).

Safely visiting in-person if needed: If things are going well, patients might only need to see their family doctor in-person once a year for immunizations, a foot check and to verify measurements. If things aren’t going smoothly or virtual care isn’t an option, more frequent in-person visits may be required. During in-person visits, family doctors make sure things are as safe as possible. Everyone wears masks (and usually goggles or a face shield), only a limited number of people are in the clinic at any time, so we have space for everyone to be six feet apart and surfaces are wiped regularly. We will also ask you some health screening questions before you come in and ask you to wear a mask to reduce risk of COVID-19 spread.

Taking care of mental health: Looking after mental health is an important foundation for diabetes care. The pandemic is putting added pressure on all of us but programs like Wellness Together Canada and Prosper Canada’s Financial Relief Navigator offer self-help resources, free counselling and financial advice.

Remember, we are here for you: The pandemic is affecting all our lives in unexpected ways. But our response to COVID-19 doesn’t have to eclipse other health needs.

Virtual care doesn’t have to be impersonal. During this pandemic, it’s more important than ever for family doctors to work hand-in-hand with patients to ensure everyone gets the care they need.

 

This advice is adapted from ‘virtual first’ diabetes care recommendations developed by family doctors and diabetes specialists at the University of Toronto’s Department of Family and Community Medicine, Diabetes Canada and the Centre for Effective Practice. A full copy of the recommendations for family doctors is available at https://cep.health/clinical-products/type-2-diabetes/