New Paradigms in Diabetes Management From the Epicenter

摘要

I have learned, more than ever before, as a clinician and researcher, that creativity and flexibility are needed to provide clinically useful and emotionally supportive care for people with diabetes. Our outpatient diabetes center in New York City, an epicenter of the COVID-19 pandemic, has rapidly transitioned almost exclusively to telemedicine visits with patient-initiated glucose-management device downloads. Within a four-week period, this has become the new treatment paradigm for patients in New York City and across the country. Implementation of this new approach has necessitated flexible, rapid training of clinical and support staff to ensure the provision of timely and clinically rigorous support. At our diabetes center, it quickly became clear that if telemedicine were to be successful, patient education and flexibility on its use would be imperative, particularly for older adults and those with less technological comfort. Many early telemedicine visits led to disconnections, lack of uploaded data, and patient frustration. To address these challenges, our diabetes team engaged staff both onsite and remotely to provide instructions in advance of visits for device downloads and telemedicine connections.1,2 This creative approach has made these remote interactions more efficient and, synergistically, has enabled our patients and providers to feel supported during these times of social isolation.