Diabetes Care During COVID-19 Pandemic in Singapore Using a Telehealth Strategy

Abstract

Singapore currently has one of highest number of confirmed COVID-19 cases in Southeast Asia. To curb the further spread of COVID-19, Singapore government announced a temporary nationwide lockdown (circuit breaker). In view of restrictions of patients’ mobility and the enforcement of safe distancing measures, usual in-person visits were discouraged. Here we describe how diabetes care delivery was ad hoc redesigned applying a telehealth strategy. We describe a retrospective assessment of subjects with diabetes, with and without COVID-19 infection, during the circuit breaker period of 7th April to 1st June 2020 managed through Tan Tock Seng Hospital’s telehealth platform. The virtual health applications consisted of telephone consultations, video telehealth visits via smartphones, and remote patient monitoring. The TTSH team intensively managed 298 diabetes patients using a telehealth strategy. The group comprised of (1) 84 inpatient COVID-19 patients with diabetes who received virtual diabetes education and blood glucose management during their hospitalisation and follow-up via phone calls after discharge and (2) 214 (n=192 non-COVID; n=22 COVID-positive) outpatient subjects with suboptimal glycaemic control who received intensive diabetes care through telehealth approaches. Remote continuous glucose monitoring was applied in 80 patients to facilitate treatment adjustment and hypoglycaemia prevention. The COVID-19 pandemic situation mooted an immediate disruptive transformation of healthcare processes. Virtual health applications were found to be safe, effective and efficient to replace current in-person visits.

Changes in dementia diagnoses in Sweden during the COVID-19 pandemic

“…We suggest that healthcare systems should take actions to mitigate this shortcoming by allocating resources to primary care and geriatric clinics in order increase screening and diagnosis of new dementia cases. Decrease in registered dementia cases during 2020 might have been mitigated by the implementation of remotely accessible consultations, so called telemedicine, a strategy that has been applied in other countries [ 31 – 33 ].…”

Under COVID-19 Pandemic: A Quasi-Experimental Trial of Observation on Diabetes Patients' Health Behavior Affected by the Pandemic From a Coaching Intervention Program

“…It seems that the changes in healthy lifestyle caused by the pandemic are varied in different countries (25), but many scholars still suggest that effective home physical activity and healthy eating strategies should be developed to help chronic patients maintain their health status (26,27). During this period, telephone coaching or counseling can be a suitable and effective method as well (28,29), and many studies have even confirmed the effectiveness of telephone coaching before the pandemic (30,31). Therefore, our study results indeed verify that behavioral coaching should help people with type 2 diabetes maintain a good lifestyle during the pandemic and even continue to improve their blood sugar control.…”

Effectiveness of a nurse‐led smartphone‐based self‐management programme for people with poorly controlled type 2 diabetes: A randomized controlled trial

“…Singapore was one of the first countries in Southeast Asia to report confirmed COVID-19 cases and in less than a month from the first reported case, had the largest number of positive COVID-19 cases in the region. To cope with the rising cases and curb further spread of COVID-19 infections, resources were re-deployed to support acute essential services and non-critical outpatient and chronic care facilities were temporarily suspended (Lian et al, 2021). With the added public health advisories that those with diabetes and other chronic conditions were at increased the risk of hospitalization and death from COVID-19 (Caballero et al, 2020), the HRQoL of people with diabetes may have been adversely affected in this period as they grappled to adjust to new practices.…”