Health care systems in Czechia had to adapt to many challenges during COVID-19, one of which was caring for patients with diabetes. WHO supported the use of telemedicine, including continuous glucose monitoring technologies, to allow patients to share personal health data with doctors at a distance, enabling many to stay in control of their diabetes during the pandemic.
Distance care is vital given that diabetic patients who become infected with COVID-19 are at a higher risk of suffering with severe complications from the virus. This is especially true for patients whose condition was not under control prior to catching the virus. Access to treatment and care was made more difficult by disruption to health care services during the pandemic.
“Countries with community transmission of COVID-19 were the most affected by the disruption of health care services,” says Dr Srđan Matić, WHO representative in the Czech Republic. “Introducing telemedicine in the Czech Republic has been a game changer to continue the provision of essential health services while the virus was spreading in the community.”
Telemedicine limits disruption
Sharing health information at a distance allows patients to receive electronic prescriptions for antidiabetic drugs, without needing to visit a doctor’s office. Modern diabetes technologies, like continuous glucose monitoring or smart glucose meters, as well as phone calls, emails and video calls, are also useful. Other methods of data sharing include exporting data from smart devices or creating charts using spreadsheets.
“Telemedicine can be used to check diabetic foot ulcers by examining photographs,” highlights Dr Martin Prázný from the Czech Diabetes Society. “This method, along with the use of clouds to share data from continuous glucose monitoring or smart glucose meters, demonstrates great progress made towards maintaining a high level of diabetes care,” he adds.
While it was possible to maintain the stable condition of many patients without any disruption, some disparities emerged limiting the use of telemedicine for patients who were older or those with lower socioeconomic status or a cognitive impairment. This needs to be taken into account in the management of patients with limited access to health care.
Diabetes and COVID-19
Adequate health care and good communication between medical staff and patients are keys to the successful management of diabetes, reports Dr Prazny, adding that “inadequately controlled diabetes can impair the function of the immune system, thus increasing the body’s susceptibility to COVID-19, and may also be associated with poor outcomes”.
Dr Prazny stresses the importance of prevention, early diagnosis, and appropriate treatment of the disease. He explains that therapy for diabetic patients with COVID-19 is more challenging because of fluctuations in blood sugar levels and the presence of other diabetic complications, especially those affecting the cardiovascular system.
According to the Czech Diabetes Society, diabetes affects 10.2% of the adult population in the country, with 80% of patients being treated with antidiabetics. Unknown cases of diabetes may represent another 1–2% of the total population, with the number increasing over time in men, and decreasing slightly in women.