This guideline was produced by NHS England in association with the Royal College of Physicians and the Association of British Clinical Diabetologists. It is part of a series of specialty guides for patient management during the coronavirus pandemic.
This summary refers only to the management of patients with diabetes in primary care during the COVID-19 pandemic. For information on secondary care and obligatory hospital admission and inpatients, see the full guideline.
This guidance is correct at the time of publishing. However, as it is subject to updates, please visit the full guideline to confirm the information is accurate.
- Diabetes services should look to maintain and optimise the health of individuals within their services over the course of the pandemic, and should not underestimate the importance of these contributions to the overall health service response
- Some services should not be postponed/cancelled if at all possible, due to acuity and potential impacts, e.g. risk of amputation in the context of active diabetic foot disease
- Some non-urgent patient contacts could be postponed, but there may not be sufficient capacity in the future to ‘catch-up’, so it should be acknowledged that postponement will equate to cancellation in a proportion of cases
- Many contacts can be performed remotely (telephone, email, video conferencing), although the reliance on biochemical parameters to inform clinical management decisions in diabetes means that the associated need for, and access to, phlebotomy/blood testing must also be considered
- Specific visits for blood testing should only be arranged if the results are felt likely to change management. The service performing the remote consultation should make arrangements for the blood testing where necessary, eg a secondary care clinic remote consultation should determine if blood testing is required and, if it is, should arrange for phlebotomy rather than assuming patients can attend their GP practice for routine blood testing without prior agreement
- Group-based face-to-face contacts should be avoided, and replaced with remote contacts, or if necessary, one-to-one face-to-face contacts
- Avoid unproductive attendances at hospital. Senior decision-making at the first point of contact should reduce or even prevent the need for further attendances
- Clinicians may need to work in unfamiliar environments or outside their sub-specialist areas. They will need to be supported
- The possibility of a seven-day service may need to be considered
- These suggestions do not comprehensively cover all diabetes services that any particular provider may be delivering, but do provide a framework for considerations and prioritisations.
Primary care delivered diabetes services
Implications for routine diabetes care should be considered in the context of broader long-term condition management and prioritisation, taking into account individual risk factors and clinical needs.
NHS England. Clinical guide for the management of people with diabetes during the coronavirus pandemic. NHS, 2020. Available from: www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/speciality-guide-diabetes-19-march-v2-updated.pdf
Published date: 19 March 2020.